Term Paper on "Hardship Letter - Nutritional Analysis Case History"

Quoted Instructions for "Hardship Letter - Nutritional Analysis Case History" Assignment:

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Nutrition and Lifestyle Management

Coursework 1: An assessment of your own diet.

Written practical assignment (2000 words +/- 10%).

Background

You are analysing your own diet, so you are the subject of the study.

Your reaction to this exercise will be mixed. It is a time-consuming exercise and needs to be

done carefully in order to be as accurate as possible. If you do not carry it out as accurately

as you can, the results will be less meaningful. The rewards usually outweigh the

drawbacks, and, while you may not feel it at the time, many students do come back and say

to me that they have found the exercise illuminating, informative and often reassuring. (No

doubt there are some who are still cursing me for years to come!)

Be objective about the exercise and try not to get emotionally involved!!

In completing this piece of work you will be able to demonstrate that you have succeeded in

gaining a comprehensive knowledge and understanding of the following areas:

• The current state of knowledge of requirements for macronutrients and

micronutrients.

• The health problems linked to an excessive or deficient intake of certain nutrients.

• the fact that food and drink are not taken at random, but in the context of social

exchanges among people and within social institutions such as the family and that

food intake patterns are strongly influenced by geographic, economic and *****cultural*****

factors.

You will also be able to demonstrate:

• competency in the use of computer databases for dietary analysis, in analysing

results, and in the presentation of results in graphical and tabular form

• a critical understanding and approach to the research context of the subject area by:

o Being able to relate theory to practice by demonstrating the ability to adapt

dietary advice to meet the particular needs of the individual.

o The ability to discuss the role of diet and appropriate supplementation for

specific conditions

o An awareness of safety issues surrounding dietary advice in practice.

Sections of the Assessment and Requirements for the Report.

The exercise will involve the following parts.

Part 1: Case history:

You should present a short case history for yourself as the *****˜patient***** or *****˜client*****. This

should not exceed 250 words. Any factors that might impact on dietary advice that

will be given should be considered. These might include family history or personal

medical history, for example of diabetes, hypertension, high blood cholesterol etc;

desire to lose weight or gain weight; compliance issues.

Part 2. Method

You should include a brief method section. Detailed methods can be placed in an

appendix for reference. Information such as the methods/equipment used for

weighing and measuring, the days on which the dietary analysis was performed, the

computer programme used etc should be included.

2

a) Recording your diet:

You will record your typical food intake. To get a reasonably accurate idea of your

average intake, record all meals, snacks and drinks, including water consumed over

3 days. The 3 days must be consecutive and include 2 weekdays and one

weekend day i.e. Thursday, Friday and Saturday OR Sunday, Monday and

Tuesday.

The method for recording your diet will be introduced in week 2 and you will need to

use the designated forms and procedure given then. These will also be available

on OASIS. Include the record in an appendix to your submitted work.

*Recording procedure

Include all snacks, condiments and spices, tonics, alcoholic drinks, sweets, etc.

All snacks, meals and drinks consumed away from home must be recorded

Begin each day on a new page of the record form

Record the day of the week and the date at the top of the record form

Record each item of a composite dish on a separate line

Record where and what time each snack, meal or drink was consumed.

*how to describe food and drinks

1. method of cooking

2. kind of food (raw or cooked; peeled or unpeeled etc)

3. Brand names where appropriate

4. include all condiments (pickles, sauce, etc)

5. provide as much information from the label as possible about any unusual or special food

* how to record amounts of foods and drinks

1. record the amounts of all food and beverages in the form they are consumed

Eg. Do not record the weight or size of a raw potato or piece of meat but the amount of it in the cooked form

*Calculation of nutrition intake

Nutrition intake can be calculated using food composition table or using a computer program and nutrient database. You can make your choice

1. nutritional analysis tool 2.0 (NAT 2.0)

http://nat.crgq.com

this is an online nutritional analysis programme that you can access on the internet.

Important notice:

It is important to remember that this programme compares the an*****d diet against American RDA*****s. you will need to compare your nutrient intake over the 3 days against the British DRV*****s as set by COMA (1991). These figures are given below. You will need to calculate your intake as a percentage of these figures for your assignment.

2. mypyramid.gov

http://www.mypyramid.gov

Again, American website, so you will need to an***** your diet but compare the nutrient intakes against UK DRVs and not the American ones.



b) Analysing Your Diet

Having recorded everything you have consumed over 3 days you will need to

calculate the nutrient content of the food eaten. You can do this using a computer

programme.

. Include the print outs from the dietary analysis as an appendix to your

submitted work.

Part 3. Results

a) Intake of nutrients as a percentage of UK Dietary Reference Values (DRVs).

Using your dietary analysis, you will record your intake as a percent of UK DRVs in

a table in a format similar to Table 1 given below and also as a graph (call the graph

Figure 1 and give it a full title).

Please note that you are expected to compare intake against current UK values and

not American values which are different for some nutrients.

Think hard about the best way to present the results as a graph that makes then

important issues easy to understand.

You should include the nutrients given here but you can add other nutrients if you

consider these important in this particular dietary analysis. If you include them you

will have to justify their inclusion in your discussion.

Table 1: Intake of nutrients as % of UK Dietary Reference Values (3 day weighed

intake: subject information ........)

nutrient

3 day average

3 day average intake as a % of UK DRVs

Protein





Carbohydrate





Calcium





Iron





Vitamin C





Sodium





Zink





Non-starch polysaccharides

(Dietary fibre)





Vitamin A





Folate (Folic Acid)





Vitamin B6





Vitamin B12





Include other nutrients if important





b) Energy Intake.

You will need to calculate the proportion of calories derived from each of the

macronutrients i.e. the proportion of total energy intake that protein, fat and

carbohydrate contributes. Alcohol also provides energy if you consume it.

You should present this in the format of the following table and also construct a pie

chart to represent this information.



Table 3: Distribution of energy intake in the diet: (mean of 3 day weighed intake;

subject information ...)

Nutrient and alcohol

Recommended percent of total calories (from UK guidelines)

Percent of total calorie intake derived from each dietary source

Carbohydrate





Protein





Total fat





Alcohol





c) Anthropometry.

Evaluate health risks associated with weight and estimates of body fat composition.

You should present this information and any other data that you might think relevant

in the table below. For information on BMI see:

http://www.who.int/bmi/index.jsp?introPage=intro_3.html

Waist-to-hip ratio: divide the measurement of your waist by that of your hips (men:

ratio ideally _ 0.90; women _ 0.85)

Waist circumference: Men: _ 94cm increased risk; _ 102cm substantially increased

risk; Women: _ 80cm increased risk; _ 88cm substantially increased risk.

Table 4: Results of Anthropometric Measurement (Subject details...)

Anthropometric measurements

Subject measurements

Standard of range considered healthy (WHO)

BMI

26.45



Waist circumference (cm)

85



Waist to hip ratio

0.85



d) Energy intake and output:

Estimate your energy output and compare this against your current energy intake.

Present this in a table as indicated below.

Table 5: Average energy intake and output

Average energy intake over the 3 days

Estimated energy output

% difference between average daily intake and output







Part 4: Evaluation of your diet and Discussion:

Your evaluation needs to address the results of your dietary analysis i.e. your

findings. Use the list below as a guideline for your write-up but this is not

exhaustive and should be tailored to your particular *****˜client***** and their diet and needs.

You need to write in a scientific style (see the next section) and you must back up

any assertions you make with evidence, citing relevant literature throughout.

a) Using the information from Table 1, evaluate how your diet compares to DRVs.

Think about nutrients which you consumed less than 75% of your DRV and

those nutrients consumed in excess of DRVs.

b) How does the diet an*****d compare to dietary guidelines and goals for

carbohydrates, fats (types of fat), protein, and alcohol as a % of total energy

intake.

c) How does your diet compare to dietary guidelines and goals for non-starch

polysaccharides (*****˜fibre*****)?

d) Is the energy intake appropriate for the subject (you)? Why/why not? Think

about body weight, BMI, whether you are gaining or losing weight etc

e) Salt intake: consider whether salt intake is too high and discuss approaches to

bringing this to within current guidelines (see

http://www.food.gov.uk/healthiereating/)

f) Evaluate how your diet compares to UK dietary guidelines; (see

http://www.food.gov.uk/healthiereating/eatwellplate/;

http://www.nutrition.org.uk/home.asp?siteId=43§ionId=874&subSectionId=3

20&parentSection=299&which=1)

Be sure to address each of the guidelines and support your answer using

information from your results tables.

g) Based on your responses above, identify changes that you would recommend to

improve the diet for this *****˜client*****

• Describe how these dietary changes could be accomplished.

• Discuss why these changes may benefit the health of this subject (you) or

help prevent disease in the future.

• If your diet is adequate in every way and there is no room for improvement,

explain what makes it so good.

• Discuss any barriers that exist that might make it difficult for this subject

(you) to make changes to diet and lifestyle or that might lead to reverting to

the old diet after a time (Compliance issues). How might you as a practitioner

help the *****˜client***** with the *****˜stages of change***** involved? Refer to models of

compliance and the change process(weeks 1 and 2)

• Dietary recommendations: A summary table of your recommended changes

including changes in the food eaten should be included. Make this easily

accessible; imagine you were giving this to a client to help them comply with

the advice you are giving.

Part 5: Reference List

Make sure you provide a full reference list. Use the guidelines given on the

LR webpages *****“ Referencing for health and Social Sciences

5

Scientific Report Writing.

"The preparation of a scientific paper has almost nothing to do with literary skill.

It is a question of organization."

--Robert A. Day, How to Write and Publish a Scientific Paper

When writing-up a practical exercise such as this it is important to remember not to

regurgitate chunks from textbooks or from any other source. You should aim to show that

you understand the aims of the dietary assessment exercise and the significance of what

you were able to find out; that you are able to present data in a clear and concise way and

that you can interpret and fit your results into a theoretical framework.

You should try to write in a way that is easily understood and grammatically correct. Use full

sentences and check the spelling. Scientific writing is usually in the past tense because you

are reporting on an exercise or experiment that has been completed. However, when citing

a published result it is etiquette that you refer to it as a fact in the present tense, e.g. *****DNA

has a double ***** structure (Watson and Crick 1953)*****.

It is also a convention in science writing to use the passive voice. In other words, instead of

writing *****I an*****d the data...***** you would write, *****The data was an*****d...*****. However, it is ok

to use the active voice wherever it is not too self referential e.g. rather than saying that *****The

food was eaten by the dog*****, you can say that *****The dog ate the food*****.

Structure.

Your report should always start with the title and end with references.

In between, for this assignment, you need to include the results and evaluation as described

above in sections 3 and 4.

Title:

You should give the work your own title (not the title of the assessment as given).

Your title should describe contents clearly and precisely.

Advice:

• Avoid wasted words such as "studies on," "an investigation of."

• Avoid abbreviations and jargon

• Avoid "cute" titles.

• Unacceptable: An Investigation of body temperature change during and after

exercise.

Unacceptable: Body temperature: are we hot after exercise?

Acceptable: Body temperature change due to exercise.

Results:

• Graphs should be used where data shows a trend e.g. body temperature

measured over a day at hourly intervals.

• Graphs must be adequately labelled and calibrated. Graphs and drawings are

called *****figures***** and labelled *****Figure 1*****, *****Figure 2***** etc., in the sequence to which

they are referred in the text.

• You should draw graphs on a computer but keep special effects to a minimum

please!

• All graphs should have a title. The title should give enough information to explain

what is shown and give enough indication of the subject/method etc. to interpret

the graph without referring back to the text.

6

• Carefully consider what sort of graph you should be using e.g. bar chart,

histogram, line graph. If you are not sure, either look it up in a text book or ask a

tutor.

• Tables should be used as indicated and should be used if there is no trend or if

exact numbers are more important. Tables should be labelled *****Table 1*****, *****Table

2***** etc. Tables should be given a title at the top with any explanation and

comments given at the bottom of the table in the form of footnotes.

Discussion:

What do your observations mean?

What conclusions can you draw?

In the discussion you should comment on your results, interpreting them in the light of the

published literature. You should try to draw your own conclusions. Keep your explanations

brief and very relevant. Try hard not to simply repeat the text from your results section.

Advice:

• Move from specifically discussing your findings to discussing them in the light of

the literature, theory and practice.

• Make explanations complete.

• Give evidence for each conclusion i.e. from the literature.

• Discuss possible reasons for expected and unexpected findings.

• Don't over generalise.

• Don't ignore deviations in the findings.

References:

Basic rule: list a reference for every idea or statement not your own.

You should read text books, journal articles and use other sources to write your report and

then cite these sources in the body of the text as well as list them in a reference list at the

end. As a level 3 module, you are expected to use primary sources i.e. peer reviewed

journal articles, not only text books (secondary sources).

References should be made using the recognised format chosen by the University. If you

are unsure of the way to reference and to format references, make use of the information

provided in the library and on the intranet (Referencing and citation Style; Health and Social

Sciences: http://www.lr.mdx.ac.uk/Helpsheets/Study%20Skills/HSS.pdf).

You should list a reference for every idea that is not your own. When we talk about

plagiarism it does not only mean copying something word for word, it also covers using

another person*****s ideas without acknowledging that person. You not only have to reference

the authors of books and papers, but also web sites accessed and other people with whom

you might have worked with to produce the lab report. If, for example, you work in a group in

the laboratory and someone else in the group comes up with an idea that you use you

should acknowledge as a personal communication (S. Trop, pers. comm.).































Dietary Reference Values

Adapted from COMA 1991, Dietary Reference Values for food energy and nutrients for the United Kingdom



Male (19-50 yrs)

Energy (EAR)

2550kcal/d

Protein (RNI)

0.75g/kg body weight

Total fat

33% of total dietary energy

Saturated fat

10% of total dietary energy

Monounsaturated fatty acids

12% of total dietary energy

Polyunsaturated fatty acids

6% of total dietary energy

Carbohydrates

50% of total dietary energy intake

Fibre-non-starch polysaccharides

18g/d

Vitamin C

40mg/d

Thiamine

1.0mg/d

Riboflavin

1.3mg/d

Niacin

17mg/d

Vitamin B6

1.4mg/d

Folacin

200μg/d

Vitamin B12

1.5 μg/d

Vitamin A

700 μg/d

Calcium

700 mg/d

Iron

8.7 mg/d

Potassium

3500 mg/d

Sodium

1600 mg/d

Zink

9.5 mg/d



















Subject information

Subject: Mr A

Date of Birth: 18. 03. 1978

Marital status: married

Occupation: Full time student

Nationality: South Korean

Home address: London, UK

Height: 175cm Weight: 82.6kg

BMI: 27

Fat: 16.5% (13.6kg)

Lean: 83.5% (69kg)

Dry lean weight: 20.4kg

Water: 58.8%

Water 48.6 liter

BMR: 2101 kcal

BMR/body weight: 25.4kcal/kg

EAR: 3152kcal

Activity level: Med (plays basketball once a week, goes gym twice a week)

Waist: 85cm

Hip: 100 cm (Waist to hip ratio: 0.85)



Please use

Nutritional Analysis Tool version 2.0 (NAT 2.0) http://nat.crgq.com

to an***** the food intake explained below



Record of dietary intake on Thursday 22nd 2009



10 am /1 apple, 1 cup of green tea /home

11 am chewing gum 1 / street

1 pm /tuna sandwich, 200ml milk, chewing gum 1 /café

7pm~ T bone steak, 1 glass of red wine / outback steak house



Record of dietary intake on Friday 23rd Jan 2009



10:00 home/ milk-cow-lowfat-past&raw-fluid-2%fat-w/added vit a 200ml

10:00 home/ waffles-buttermilk-prepared from recipe 60g

2:00 pm pizza hut/ thin*****n crispy pizza with ham, 4 slices 292g

2pm pizza hut/ orange juice 200ml

3:00pm outside/ chewing gum, 1 pc 5g

8pm home/ pork-fresh-loin-center rib boneless-sep lean and fat-cooked-pan fried 300g

8pm home/ lettuce-looseleaf-raw, garlic-raw 5 pieces

10pm pub/ alcoholic beverage-beer-light 4 pints

10pm pub/ peanuts-all types-oil roasted-w/salt 50g

Record of dietary intake on Saturday 24th 2009

2pm home/ orange juice (Sunkist pure) 600ml

7pm sushi bar/ tuna sasimi 600g, wasabi (Japanese horseradish) 1 tea spoon, soy sauce 10g,

Rakyo(pickled spring onion) 20g, miso soup 100ml, beer 6 pints,