Michelle McCall

FND 430 Nutrition Assessment Project

Analysis of L21’s nutrient needs

L21 is a healthy female who is 5ft 4in tall and 21 years of age. Her BMI is healthy at 20.5

(normal BMI range=18.5–24.9). She weighs 117lbs but her calculated ideal body weight is 124lbs,

making her ideal body weight percent 94.35. This shows that she is almost on par with her ideal body

weight and is healthy. We began our meeting with a 24 hour food recall. This method was convenient

for her, and gave me some insight to her diet lifestyle. The 24 hour recall got us talking about more than

just the food she ate the day before; it gave her a chance to share that she does not eat meat, except for

seafood. She also mentioned that she lives with and cooks for her boyfriend who is a picky eater and it

has affected her eating habits.

Then L21 took the MEDFICTS Dietary Assessment Questionnaire so I could have more

information about her use of foods and food frequency. Her total score (54) revealed that she has a

heart-healthy diet because it falls in the normal range of 40-70. This method was quick and covered all

the food groups. Together the 24 hour recall and the food frequency assessment gave me a good view

of her diet habits, so we could start talking about where she was at and what her goals were with food.

L21 hasn’t had any dietary intake changes in the past 3 months and has no GI symptoms or

issues. L21 had a Subjective Global Assessment rate of A, meaning she is well nourished. She is

functional, eats three meals a day and has snacks occasionally. Her intake of water is good, the AI for

women is about 9 cups a day. She is well hydrated based on her 24hr recall because she reportedly had

75oz that day (~9cups). Her Blood pressure was a normal 113/65 and her blood glucose was 204mg/dL.

She had been fasting a few hours before the taking her BG. A normal blood sugar level two hours after

eating is less than 140 mg/dL so it was in a healthy range.

Next we developed a care plan to attack her goals of increasing her protein intake and

increasing her strength. Something that would improve her quality of life. Her anthropometric

measurements from her skin fold tests said she has a medium frame (60). This isn’t consistent with what

I observed when taking the measurements though, L21 has a normal frame size. At each site I did 3

tests, at site #1 the results were 26/22/26; fairly consistent values indicating little fat deposit. Site #2,

the superillium skin folds were 13/15/15 respectively. Site #3 her thighs had the largest and most

variable results (36/52/47). This indicates human error on my part, that my measuring was not very

accurate. Her calculated % Body fat is 31%, which may be high because of the thigh skin fold tests that

were inaccurate. The care plan developed for patient L21 involves:

Nutrition education on sources of protein. As well as using goal setting to guide L21 to increase her

protein intake and increase physical strength.

L21 now knows that her protein intake should be 42.5g/day and that her results from her 24hour recall

in the nutrition summary tells us that she got 71% of her protein that day. This mean she could use to

increase her intake to be healthier and meet her protein needs.

Outcome Goals:

1. Increase in physical strength

2. Increased protein intake (meeting 42g/day)

3. Muscle development

Action Goals:

1. Client agrees expand diet to include high protein supplement snacks or foods

2. Client agrees to continue her 3 days a week of exercise, but not limited to.

3. Client will try new ways of exercise such as rock climbing to build muscle

4. Incorporate seafood into diet more frequently since she doesn’t eat other meat sources.

I will continue monitoring and evaluation by follow-ups with client L21 in 1 month to assess

attempted dietary changes and physical activity status, as well as quality of life changes. Reviewing L21s

diet record on my pyramid analysis shows that she should up her milk intake, which is 1.3c/day when it

should be 3c/day. This would help her meet her protein needs as well. Overall L21 is ready to change her

lifestyle but a few risks and barriers to this are money, because she can’t afford to try new supplement

snacks or protein powders or seafood every week, and she doesn’t care for lentils (a cheaper source of

protein). Her boyfriend that she cooks for has a big influence on what they are eating each night for

dinner, so we discussed how this has led to more prepackaged foods being made. These are barriers are

very real but because she is healthy and is getting adequate protein in her diet, she is not at risk of

protein wasting.

I recommend that she tries protein bars, supplements, ect. to get her protein intake to be 90-

100+% and to continue to be physically fit and active. As she is L21 is doing well nutritionally as all of her

labs and test results were in normal and healthy ranges.