For dinner we planned on giving butter chicken cooked in Indian style.

Previously, the
patient consumed anchovies and salted fish for dinner. Therefore, we plan a chicken-based meal as
chicken is a lean meat that has lower sodium number and low saturated fat. We used chicken breast
without skin as the breast part is the leanest and the skin is quite high in fat (Frey, 2022). Chicken is
also a good source of vitamin B, vitamin D, calcium, iron, zinc, and vitamin C which is needed for
fetal growth. Butter chicken also contain ingredients like potato, tomato, yoghurt and some herbs
and spices. Tomato contains high potassium which helps decrease sodium intake as it helps widen
the arteries. Tomatoes are also a great source of naturally occurring folate. (Ware, 2017).
Meanwhile, potato is also a source of carbohydrate that is low in sodium. This helps to reduce the
consumption of rice as it is fulfilling which helps in managing weight (Raman, 2018). Furthermore,
we substitute the use of cooking cream in the original recipe to yoghurt since it contains lesser
sodium and probiotics that can help improve the metabolic health of the mother. On top of that, low
fat dairy products like yoghurt appear to be especially beneficial for lowering systolic blood pressure
(Wade et al., 2021). Moreover, to reduce the sodium consumption, we lower the amount of salt
used in the original recipe to a pinch and add variety of spices to enhance flavour. Besides, dinner is
accompanied with broccoli and cauliflower sauté. Previously, the patient does not consume
vegetable. Therefore, we want to increase the vegetable portion so that the meal become nutrient
dense and low in calories. Broccoli and cauliflower are cruciferous vegetable that contain
sulforaphane which is sufficient in regulating blood pressure. (Cole, 2019)

For supper, we planned on giving creamy chestnut oatmeal. The recipe contains oatmeal,
yellow lentils, and water chestnuts. Oats are high in fiber which helps increase the patient fiber
intake. In addition, it also helps in lower blood sugar and cholesterol levels (Palsdottir, 2022).
Moreover, yellow lentils are rich in fibre, folate and potassium which helps in managing blood
pressure and cholesterol. Lentils also contain iron which aid in increase oxygen supply to the baby.
Furthermore, water chestnuts are high in minerals. It has high potassium, magnesium, zinc, and
copper content that can help in regulating blood pressure. Water chestnuts are high-volume food
that contain either a lot of water or air (Raman, 2018). This allows patient to eat larger quantities of
food while keeping calories low.

The fiber, potassium, vitamin C, and choline content in tomatoes all support heart health.

Patient M is diagnosed with gestational hypertension on her 18 th week of gestation. It is state that
the cause is high intake of salty food. Patient’s lab values also show proteinuria which indicates
preeclampsia.

Hypertension is when blood pressure is too high. Blood pressure is the force exerted by circulating
blood against the walls of the arteries. Blood pressure is represented by two numbers. The first
(systolic) number represents the pressure in the blood vessels when the heart is contracting or
beating. The second (diastolic) number represents the pressure in the blood vessels when the heart
is resting between beats. (World Health Organisation ,2021). Gestational hypertension is defined as
systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg
(Management of Hypertension 5th Edition, 2018).
High intake of sodium can cause hypertension. Increase of sodium can cause blood pressure to rise.
Increased salt consumption may provoke water retention, thus leading to a condition of high flow in
arterial vessels (Grillo et al., 2019).

Moreover, preeclampsia is a complication of pregnancy. Preeclampsia is when you have a high blood
pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of
organ damage (Mayo Clinic,2022). The prevalence of preeclampsia in Malaysia is 1.6% (Sutan et al.,
2022). Complication of preeclampsia during pregnancy includes fetal growth restriction, placental
abruption, hemolysis, eclampsia, cardiovascular disease, and organ damage (Mayo Clinic,2022).

a. Plan a 1800 kcal menu based on the patient's energy requirements to maintain calorie
intake.
b. Educate the patient on how to reduce sodium intake through diet such as using herbs
and spices and avoiding processed foods.
c. Advise patient to avoid high saturated fat foods like fried foods. 
d. Educate patient on how to reduce saturated fat intake by choosing healthier food
choice such as replacing cooking cream with yoghurt.
e. Advise patient to choose products with low sodium levels and higher levels of
potassium, magnesium, and calcium content instead. 
f. Increase vegetable and fruit intake by consuming at least three servings of vegetables
and two servings of fruits daily. 
g. Increase intake of nutrients like folate, vitamin C, vitamin D, iron and calcium.
h. Use healthy cooking methods that use less oil, like grilling, boiling, and roasting.
i. Limit caffeine consumption to 200mg per day.