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Your analysis you need to discuss the consequences of not achieving a balanced diet and provide recommendations on how the diets could be improved.

Michael is married with two teenage sons and is 42 years old. He works long hours. At weekends he enjoys watching sports programmes on TV, but due to an injury in a football match some years ago he is no longer able to swim or play football. He and his wife both drive cars and enjoy eating out. His current weight is 98kg and he is 1.78m tall.

Michaels’ total energy and nutrients for a typical day are outlined in the table below.

Energy

11,347kJ

Fat

151g

Of which saturated fatty acids

51g

Monounsaturated fatty acids

47g

Polyunsaturated fatty acids

38g

Carbohydrate

222g

Of which starch, intrinsic & milk sugars

168g

Non-milk extrinsic sugars

54g

Calcium

960mg

Vitamin C

78mg

Fibre

14.3g

Stephanie is trying to get pregnant but to date has had little success. She is 31 years old, 5 feet 4 inches tall and her current weight is 5 stones and 10 pounds. Her waist measures 25 inches and her hips measure 33 inches at the widest point. She wears size 6 clothes but these are loose fitting.

During a recent visit to her GP blood tests were taken which revealed that Stephanie is suffering from Anaemia.

Stephanie needs to know what dietary changes she needs to make in order to increase her chances of conceiving and what eating habits she should adopt should she become pregnant.

Imran is 12 years old and an avid gamer. He spends any time that he isn’t at school on his games console usually with curtains drawn so he can see the screen properly. His sister Ghazala complains to their mother that all he does is sit in his room, in the dark playing games and eating rubbish such as sweets and crisps. As a result, he is becoming overweight. Imran tripped whilst leaving the house for school one morning and was rushed to A&E.

Discussion

The following paragraphs of the essay, aim to shed light on the key dietary issues presented by the given scenarios, followed by consequences of consuming and imbalanced diet and recommendations concerning required dietary improvements.

Dietary Scenario 1

Consequences

It can be observed that Michael’s consumption of carbohydrates derived from sugars as well as saturated fats are in excessive amounts as compared to the recommended guidelines by the British Nutrition Foundation (Recommended 5% sugars, 11% Saturated Fats) (Scarborough et al. 2016). Michael engages in negligible levels of exercise and excessively consumes fast food, further putting him at an increased risk for harmful trans fat consumption and positive energy balance as evident in his high Body Mass Index of 31 kg/m2. Lack of adherence to a exercise and a diet containing high amounts of saturated fats, trans fats and sugars will lead to excessive calorie consumption and Michael’s future susceptibility of metabolic diseases such as diabetes mellitus and fatty streak accumulation leading to cardiovascular disorders such as atherosclerosis (Majeed 2015).

Michael must cut down on his consumption of fast food and sugary processed foods to reduce excessive calorie and saturated fat consumption. He must also opt for consuming low fat dairy products like skimmed milk or yogurt since it will reduce his fat consumption, instead of processed products as it is observed that most of his sugar consumption is obtained from milk sugar (Montagnese et al. 2015). To further reduce excessive calorie consumption, improve his metabolism and enhance his stamina and immunological abilities, Michael must also engage himself in mild physical activities with his wife, in the form of walking or yoga (Forrest et al. 2016). It is recommended that he increases his consumption of whole grains and green leafy vegetables, which will not only provide him with satiety, fiber and vitamins, but will also provide him with antioxidants to reduce oxidative stress cause due to high fat consumption (Gopinath et al. 2014).

Consequences

Stephanie has an extremely low body mass index of 13.7, making her underweight, despite possessing a normal waist to hip ratio. A low body weight or inadequate calorie consumption results in decreasing metabolic rate and a reduced production of estrogen, further reducing healthy ovulation and possibilities of fertilization in Stephanie. Even after conception, a low body weight may also increase Stephanie’s chances of producing a premature or low birth weight baby (Ko et al. 2014). If left untreated, Stephanie’s anemic status may further aggravate once pregnant, further reducing her red blood cell count and required oxygen supply to the fetus, increasing her susceptibility of having post partum depression and delivering a premature baby or  a baby with anemia and delays in achieving developmental milestones (Cantor 2015).

For healthy conception and delivery of a healthy baby, Stephanie must increase her body weight by at least 10 to 12 kilograms, which can be done through incorporation of whole grains and healthy fat sources such as almonds, walnuts and fatty fish. She must also increase her intake of proteins and calcium through incorporation of lean meats like eggs, fish and chicken and dairy sources such as milk and yogurt, which are needed for healthy tissue and bone development of the baby, should she get pregnant. She must increase her iron, cobalamin and folic acid intake by including food such as dried fruits like dates, spinach leaves, almonds, seeds, whole grains and fortified cereals, milk products, beans, organ meats and lentils which will reduce her anemia and the baby’s chances of acquiring anemia and neural tube disorders such as spina bifida. She must also increase her Vitamin C consumption through incorporation of citrus fruits and guavas for increased iron absorption.

Dietary Scenario 1

Consequences

Imran’s levels of physical activity or exercise is grossly negligible, which will increase his chances of obesity, excessive calorie consumption and production of anabolic hormones such as insulin, leading to adipose tissue accumulation and increased susceptibility to metabolic disorders such as diabetes mellitus, cardiovascular diseases and impaired immunity, further resulting in high inflammation, high oxidative stress and susceptibility to cancer (Watson 2015). Imran’s avoidance of going outside also reduces his Vitamin D status further decreasing his calcium absorption and bone mineral density, further increasing his future susceptibility of osteoporosis (Cashman et al. 2016).  

To improve his bone strength, Imran must increase his calcium consumption through incorporation of dairy sources, broccoli, soy and almonds. Vitamin D improves calcium absorption, and hence Imran must go out for increased intake from sunlight along with consumption of foods such as egg yolks, mushroom, fortified butters and cereals and juices and organ meats like beef liver (Cashman 2015). To further improve his bone flexibility, strength and reduce weight, he must engage in resistant training such as mild weight exercises, stretching, tai-chi and yoga. Incorporating these dietary and exercise changes will reduce his weight, improve his strength, stamina flexibility and reduce his susceptibility of fractures due to falls (Hinton, Nigh and Thyfault 2015).

Conclusion

Hence, upon observation of the above dietary scenarios, it can concluding that by incorporating sufficient levels of exercise and nutritious foods, a balanced diet and lifestyle will help one to prevent major disorders and complications and live a life of health and happiness.

References

Cantor, A.G., Bougatsos, C., Dana, T., Blazina, I. and McDonagh, M., 2015. Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the US Preventive Services Task Force. Annals of internal medicine, 162(8), pp.566-576.

Cashman, K.D., 2015. Vitamin D: dietary requirements and food fortification as a means of helping achieve adequate vitamin D status. The Journal of steroid biochemistry and molecular biology, 148, pp.19-26.

Cashman, K.D., Dowling, K.G., Škrabáková, Z., Gonzalez-Gross, M., Valtueña, J., De Henauw, S., Moreno, L., Damsgaard, C.T., Michaelsen, K.F., Mølgaard, C. and Jorde, R., 2016. Vitamin D deficiency in Europe: pandemic?, 2. The American journal of clinical nutrition, 103(4), pp.1033-1044.

Forrest, L.N., Smith, A.R., Fussner, L.M., Dodd, D.R. and Clerkin, E.M., 2016. Using implicit attitudes of exercise importance to predict explicit exercise dependence symptoms and exercise behaviors. Psychology of sport and exercise, 22, pp.91-97.

Gopinath, B., Russell, J., Flood, V.M., Burlutsky, G. and Mitchell, P., 2014. Adherence to dietary guidelines positively affects quality of life and functional status of older adults. Journal of the Academy of Nutrition and Dietetics, 114(2), pp.220-229.

Hinton, P.S., Nigh, P. and Thyfault, J., 2015. Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial. Bone, 79, pp.203-212.

Ko, T.J., Tsai, L.Y., Chu, L.C., Yeh, S.J., Leung, C., Chen, C.Y., Chou, H.C., Tsao, P.N., Chen, P.C. and Hsieh, W.S., 2014. Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: a birth cohort study. Pediatrics & neonatology, 55(1), pp.20-27.

Majeed, F., 2015. Association of BMI with diet and physical activity of female medical students at the University of Dammam, Kingdom of Saudi Arabia. Journal of Taibah University Medical Sciences, 10(2), pp.188-196.

Montagnese, C., Santarpia, L., Buonifacio, M., Nardelli, A., Caldara, A.R., Silvestri, E., Contaldo, F. and Pasanisi, F., 2015. European food-based dietary guidelines: a comparison and update. Nutrition, 31(7-8), pp.908-915.

Scarborough, P., Kaur, A., Cobiac, L., Owens, P., Parlesak, A., Sweeney, K. and Rayner, M., 2016. Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines. BMJ open, 6(12), p.e013182.

Watson, N., Ji, X., Yasuhara, T., Kaneko, Y., Tajiri, N. and Borlongan, C.V., 2015. No pain, no gain: lack of exercise obstructs neurogenesis. Cell transplantation, 24(4), pp.591-597.

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