A balanced diet is important in the attainment of good nutrition. A balanced diet provides the body with energy, proteins, fats, vitamins and minerals, which should be in right proportions to avoid excesses and inadequacies that lead to diseases. Deficiency diseases such as osteoporosis result from an extended period of time without taking the right amounts of nutrients in food (Meier & Kranzlin 2011). Good nutrition is a step towards achieving millennium development goals. Good nutrition reduces morbidity and mortality rates, and is important in the fight against poverty. In the contemporary world, lifestyle diseases have become a great cause of death, illness and disability (National Health and Medical Research Council 2013). This paper will discuss the essence of maintaining a healthy diet by demonstrating the effects of deficiencies and excesses of certain nutrients.
Nutrient Deficiencies and Excesses
Lisa is obese with a BMI of 39.6. The nutrients that will be of concern based on her diagnosis and weight are the macro nutrients, calcium, magnesium, fluoride, phosphorus and vitamin D. She has failed to commit to an exercise regime that could help her shed off some of her weight, yet her total calorie consumption exceeds her estimated energy requirement in relation to her age, weight and activity level. The estimated energy requirement for Lisa is 9883 kilojoules, yet upon analysis of her dietary intake, she consumes 14087.9 kilojoules. According to Savica, Belllingheri & Kopple (2010), physical activity, reduced intake of energy-dense foods and high fiber are protective factors against obesity. Obesity predisposes one to diabetes type II: insulin sensitive diabetes, hence poor regulation of sugar.
Osteoporosis is a disease marked by weak and brittle bones; hence, the reason for focusing on calcium, vitamin D and phosphorus. Calcium makes bones and teeth hard and supports their structures since it is deposited here. According to Lisa’s diet, the amount of calcium consumed is adequate because she consumes 922.2 mg per day in comparison to the estimated average requirement of 840 mg/day (foodzone 2013). But, according to the recommended dietary intake, it falls below 1000mg. This means that her intake is commensurate with her needs but inadequate in relation to the RDIs. Alternatively, there may be an issue with the absorption of calcium due to low amounts of vitamin D. Vitamin D is very important for the absorption of calcium and it recently has been linked to diabetes (National Institute of Health n. d.). This could be due to the fact that vitamin D is important in the transmission of messages between the brain and the body. Therefore, low amounts of vitamin D could mean poor transmission of messages; hence, poor regulation of blood sugar.
An analysis of Lisa’s diet shows that she consumes more proteins, less carbohydrates and upper limit amount of fat. Sodium is in excess and exceeds the upper limit requirement of 2300mg/day. Vitamin D, vitamin C, vitamin E and linolenic polyunsaturated fatty acids are inadequate. The high blood pressure is a result of excessive consumption of sodium (National Library of Medicine 2013; Frisoli, et al. 2012). According to Zhu, Kaneshiro & Kaunitz (2010), premenopausal women are at risk of iron deficiency due to menstrual loss and irritable bowel syndrome. Lisa’s diet is also characterized by inadequate intake of iodine; her intake is 132.9 micrograms in comparison to the recommended intake of 150 micrograms.
Signs for Nutrient Imbalances
The fact that Lisa has a BMI of 39.6 shows an imbalance in energy consumption. This could explain why she feels fatigued; when one is obese, insulin fails to function properly and, as a result, does not facilitate the uptake of sugar by the cells. Since the cells do not take up sugar, one feels fatigued and hungry; hence the reason why Lisa craves for sugar and feels light-headed as she lacks sugar that ought to provide her with energy. In addition, obesity is the reason why Lisa is hypertensive. Obesity is linked to fat deposition in the blood vessels. Subsequently, the volume of the blood vessels is constricted and blood is pumped with difficulty. The heart pumps little blood at a great speed resulting in hypertension. The heart is overworked, and this has detrimental effect on the heart. The high amount of LDL cholesterol is due to the high amounts of saturated fats consumed. According to Siri-Tarino (2010), saturated fatty acids are able to raise the levels of LDL by lowering the levels of LDL receptor-mediated clearance.
Dull hair and cutaneous changes are signs for multiple nutrient deficiencies: vitamin K, protein, vitamin A, vitamin C, biotin, pyridoxine, fatty acids, zinc, cyanocobalamin (vitamin B 12), niacin and riboflavin (Basavaraj, Seemanthini & Rashmi 2010). Conjuctiva pallor is due to the lack of iron. In addition, unhealthy skin is due to iron deficiency (Scientific Advisory Committee on Nutrition 2010). Vitamin B 12, which is predominantly from animals, is responsible for healthy skin and hair. Despite the fact that protein intake is adequate, high intake is associated with counterproductive effects. Cao & Nielsen (2010) have shown that a high protein intake results in mild metabolic acidosis. Metabolic acidosis interferes with the synthesis of protein, and instead, triggers breakdown that produces a negative nitrogen balance. In addition, metabolic acidosis reduces thyroid function and the result is fatigue. Dull hair and fatigue are indicators for iodine inadequacy. Iodine is important for the functioning of the thyroid hormone and is responsible for healthy growth of hair (State Government of Victoria 2013; Hessy 2010). Hypothyroidism results in reduced energy and it becomes difficult for one to engage in physical activity.
Recommendation
Short-term Goals
To develop a healthy diet
This is the first step to attaining good health for Lisa. An analysis of her diet indicates a disproportionate consumption of the macronutrients, which are key determinants of hypertension, high LDL cholesterol levels. These subsequently predispose her to more serious diseases such as cardiovascular disease and diabetes. She needs to maintain the recommended proportions of the macronutrients in relation to her estimated energy requirements: CHOs (45-65%), Proteins (15-35%) and fats (20-35%). Lisa’s CHOs should consist of complex carbohydrates. The largest percentage of fats (80%) should come from monounsaturated and polyunsaturated fats (American Heart Association 2013).
To increase calcium and vitamin D intake and reduce consumption of sodium
Lisa will place special focus on her vitamin D and calcium levels due to her weak and brittle bones. Sodium will be reduced to lower hypertension.
Iron, Iodine, vitamin C and E
These micronutrients are meant to aid in attainment of a healthy skin, lowered LDL and radiance of the general body. Adequate iodine will promote proper thyroid functioning, and thereby, Lisa will engage in physical activity.
Long-term Goals
- Lowered blood pressure.
- Increased HDL (Brehm 2013).
- Healthy bones and skin (Goldberg & Lenzy 2010).
Dietary Recommendations
- Lisa should observe the proportions of macronutrients in her diet. These nutrients are very important in controlling the morbidities of some fatal and chronic illnesses.
- Lisa should increase her consumption of calcium by eating milk and milk products, cruciferous vegetables and fortified cereals. Lisa should increase her consumption of vitamin D (Lv & Brwon 2011). Rich sources of vitamin D include animal products, fortified products and mushrooms. The use of supplements will help Lisa get her recommended amount of calcium intake, but she should seek the professional help of a dietitian (Meier & Kranzlin, 2011). The dietitian will advise her on good feeding habits to ensure maximal absorption of calcium and prevent toxicity.
- Lisa should reduce her consumption of sodium to lower her blood pressure. Lisa should reduce her consumption of processed foods to do this. In addition, she should consume home-made food containing an amount of sodium commensurate to her need.
- Lisa should increase her consumption of iodine to promote proper thyroid functioning.
- Increase consumption of animal products to increase her ferritin levels. In addition, she should take fruits and vegetables alongside these animal products to enhance absorption of iron.
- Replace refined foods with high fiber food, for example, wholegrain bread instead of white bread. This will help in excretion of cholesterol hence lower cholesterol levels and reduce susceptibility to cardiovascular disease (Dhingra, et al. 2012).
Conclusion
Good nutrition is fundamental in the achievement of good health; nutrients work collaboratively to support each other and produce collective beneficial results. The diet dictates who one is and, therefore, healthy dietary practices are important. As can be seen from the analysis of Lisa’s diet, it is possible to maintain good health with just a healthy diet. Most of the ailments that Lisa has can be prevented by adopting a healthy diet; hence, increasing one’s quality of life, reducing hospital bills and expenses, reducing poverty and stays in hospitals due to associated comorbidities.
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