PANGASINAN STATE UNIVERSITY

Lingayen Campus
Lingayen, Pangasinan

NUTRITION CARE PROCESS

CASE STUDY PART 2 : Nutrition Assessment

Name:_______________________________________ Score:

Year and Section:______________________________ Date:_________________

Mr. Robertson is a 65-year-old retiree who lives with his wife. While he was in the workforce, Mr.
Robertson's job as a construction overseer kept him active for several hours a day. Since retiring six
months ago, he has adopted a sedentary lifestyle.

Mr Robertson sees his family doctor for a general medical examination. He believes he is in good health,
and wishes to remain so in his retirement years. He gave up smoking 20 years ago. His father died from a
myocardial infarction at age 55, while his mother and older brother were both diagnosed with type 2
diabetes in their sixties, so he has concerns about the possible significance of his family history.

The doctor undertakes a physical examination that includes blood3 pressure, weight and height. Blood
pressure measures 130/85 mmHg; weight is 198 lb (90 kg): both are higher than previous recordings. The
doctor thinks that, if there is any further increase in blood pressure, anti-hypertensive medication will be
called for; but as the first point of intervention, he recommends that Mr. Robertson see a dietitian about
losing some weight.

Mr Robertson schedules a consultation. This is his first visit to a dietitian. You collect a diet history and
the following anthropometric measurements: height 5 ft 9 in (175 cm) and weight 198 lb (90 kg). The
patient reports his weight six months ago as 172 lb (78 kg). You measure his waist-hip ratio as 1.0 and
calculate BMl at 29 kg/m 2.

Mr Robertson tells you how much he is enjoying his retirement. He loves spending more time with family
and friends. However, he has been gaining weight. His weight was never a problem during his working
life. He didn't "diet" or have to think about what he ate. But the weight gain since retirement is bothering
him. His old clothes are tight, and he needs increasingly larger sizes. He is considering modifying his
eating habits but does not know where to start. He and his wife, Desiree, go grocery shopping every
Friday. She does the cooking, and he describes his diet as "good basic meals."
You discuss recreational activities and physical activity level. Most days, Mr Robertson does chores
around his small garden, and he maintains a busy social life. Every Monday he goes bowling, and
afterwards has a cup of tea and fruit cake with friends. He bowls for a total of 60 minutes weekly. He
walks slowly for 30 minutes per week and gardens daily for 15 minutes. Apart from this, he does not
participate in any other physical activity.

On Wednesdays, Mr Robertson goes to the cinema with his film club. He has a chocolate- coated ice
cream. During the Friday grocery-shopping trip, the couple likes to buy a cake or donuts for when they
get home. On Friday and Saturday nights, Mr Robertson watches the football on television and snacks on
potato chips. He loves treating the grandchildren chocolates on Sundays, and he enjoys two fun-size
chocolate bars then.
 NUTRITIONAL ASSESSMENT

I. Calculate BMI values for Mr. Robertson.

HEALTH STATUS AGE ( years) HEIGHT ( in cm) WEIGHT(lb/kg) CALCULATE

BMI (kg/m 2.)
Six months prior to first 64.5 5’9” (175) 172 (78)
consultation
First consultation 65.0 5’9” (175) 198 ( 90)
weight management

II. Plot the BMI trend on this graph using BMI values set out above.

MR. ROBERTSON’S BMI GRAPH- ADULT WEIGHT MANAGEMENT

Morbidity Obese
35
Body Mass Index ( kg/m2)

Obese
30

Overweight
25

Healthy Weight
20

Underweight
15

Severly Underweight
10

64.5 65

Age ( Years)

III. Calculate Mr. Robinson’s daily energy needs using the appropriate Mifflin-St
Jeor equation ( male) .
Multiply BMR to Activity Level
Determine the amount of Macronutrients for Prescription
Translate the Diet Prescription into exchanges.