a) Discuss why the client visited you, the GP’s assessment

Case Study
MI is a 49 YOWM who is married with two children aged 14 and 19. He is of Italian decent and loves Italian
food. He takes pride in his ability to prepare traditional Italian meals. MI is a high school teacher (English
and Italian) and never exercises.
MI’s family and close friends have been concerned for many years about his weight and health and have
been asking him to do something about it. MI is now also concerned about his weight. He realises that his
love of food and lack of exercise have contributed to his weight problem. You can tell visually that he is
carrying excess weight around his abdomen and is slightly puffed from the walk up the steps to the clinic.
His anthropometric measurements are that he is 177.8cm (5’10’’) tall and weighs 96.75kg (215lb). When he
was at his healthiest and fittest he weighed 76.5kg (170lb). His wife would like him to look as good as he did
then (they met at university). He has decided that he would like to lose the weight difference
(20.25kg/45lb) and get back his youth weight. He used to be an excellent runner and would like to start an
exercise program to build up his fitness levels as well.
He has seen a GP who after the appropriate tests told him that he is at risk of CVD and type two diabetes
but does not have any current cardiovascular disease, he has slightly elevated blood pressure and
cholesterol and the GP wishes to see him again in three months to reassess the need for medication if
these factors do not reduce.
At the interview you obtained the following information:
Sleep
Very tired on waking, sleeps as late as he can, big rush in the morning
Breakfast
Occasionally eats breakfast (usually not enough time). Typically drinks a macchiato (with three sugars)
while getting ready for work.
Home-made lunch as the shops and school canteen ‘don’t sell real food’.
Lunch
Typically consist of 2 sandwiches and can of diet coke.
Sandwiches are on baguette, rye or white rolls and are filled with egg salad, chicken salad, roast beef,
salami, or ham, with mayonnaise, mustard, lettuce and tomato.
MI does not eat again until dinner.
Written Assessment Task ADVNMN113 Nutrition 1
Dinner
MI does not snack, eats a light lunch so feels as though he deserves to eat a good dinner. Either he
prepares the meal with his wife and kids, or he prepares it himself. He typically completes all of his work
when he goes home so that he can properly enjoy dinner. After dinner he and his wife clean up and he may
watch some TV and then goes to bed. Weekend meals are not usually very different however they may be
eaten earlier on Sundays and they often entertain on Saturdays and Friday nights.
The meal starts with a salad (rocket and parmesan or iceberg lettuce, olives, tomato and cucumber). Salads
are always dressed with olive oil and balsamic dressing. Pasta appears at every meal and is often spaghetti,
gnocchi, fettuccini, or lasagne. Tomato sauce, grated cheese or cheese sauces are essential. Parmesan,
Romano, mozzarella, and bocconcini are his favourites.
MI may occasionally consume crustaceans (mussels, prawns, calamari, squid, scallops, lobster, etc) and
chicken but meals typically consist of veal or beef. Everything has lots of Italian herbs and spices, sea salt
and olive oil. Garlic bread is included at every meal and is made with “real butter” and olive oil. MI insists
on using real butter in his cooking and uses fresh cream in his sauces. He uses egg batter “to keep
everything together”.
Vegetables are typically eggplant, squash, artichokes, asparagus and beetroot. They use lots of onions,
garlic, chilli and herbs and spices in the cooking. He has a herb garden outside and loves fresh herbs.
With dinner he will drink many glasses of red wine (4-8 glasses) and will always have dessert – homemade
gelato (pistachio is his favourite) and Italian pastries and biscotti.
Eating habits
Serving sizes vary depending on the combination of foods served. However excessive amounts of each food
are consumed.
MI does not eat out of boredom. He simply enjoys good food.
Questions relating to the Case Study
Answer each of the following eight (8) questions. Ensure you relate your answers to the case study and
nutritional medicine theory that you have learnt in this subject.
1) Identify presenting complaint.
a) Discuss why the client visited you, the GP’s assessment
b) Implications on his health for the future.
c) Include the BMI and how you would assess the anthropometric measurements.
2) Identify advice provided by other health care professionals
3) Formulate a client-centered treatment plan.
i.e. List and prioritise your treatment goals and justify your reasoning for the suggested intervention.



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