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Contents

Introduction of Mr. X ………………………………………………………3

Mr. X typical day - Food Diary …………………………………………...3
Calculations ………………………………………………………………..4
Type 2 Diabetes ……………………………...……………………………6
Hypertension …………………………………………………………….…6
Sluggish digestive system ………………………………………….….…7
Macronutrients ……………………………………………………………..7
Glycaemic Index (GI) …………………………………..……………….…8
Recommendations …………………………………………………………8
Food groups ………………………………………………………………...9
One day menu plan ……………………………………………………….11
Hydratation …………………………………………………………………11
Conclusion ………………………………………………………………….11
References …………………………………………………………………13

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Introduction of Mr. X

● Mr. X is a 52-year-old male

● 5 foot 10 inches (177.8 cm)
● 100 kg
● diagnosed with Type 2 Diabetes and Hypertension
● sluggish digestive system
● very tired most of the time
● sedentary lifestyle

Mr. X typical day - Food Diary

In 24 hours Mr. X’s food intake looks like this:

● white bread (8 slices) = 728 kcal
● butter (3 tbsp) = 417 kcal
● jam (2 tbsp) = 38 kcal
● tea 3 = 3 kcal
● sugar (8 tsp) = 138 kcal
● cappuccino 1 = 150 kcal
● croissant 1 = 231 kcal
● bacon (4 slices) = 172 kcal
● coleslaw (2 servings) = 158 kcal OneLineStock
● chocolate bar 1 = 240 kcal
● sirloin steak 1 = 135 kcal
● mashed potatoes (2 servings) = 500 kcal
● peas (1 cup) = 117 kcal
● gravy (½ cup) = 62 kcal
● crisps (1 packet) = 171 kcal
● biscuits (2) = 140 kcal
● water (2 glasses) = 0 kcal

Total calorie intake in 24 hours is 3 400 kcal

Alcohol - 8 to 10 pints of beer on one night of the weekend

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Calculations

Basal metabolic rate (BMR) is number of the calories that Mr. X needs to perform
basic functions such as breathing, blood circulation, cellular growth, body
temperature regulation, hair growth and hormone production.
Mr. X BMR is 1 856.25 calories/day.

Men BMR = (10 x weight in kg) + (6.25 x height in cm) - (5 x age in years) + 5
= ( 10 x 100) + (6.25 x 177,8) - (5 x 52) + 5
= 1 000 + 1 111.25 - 260 + 5
= 1 856.25 calories/day

Resting Metabolic Rate (RMR) is the amount of energy required by Mr. X’s body for
maintenance of life over a 24-hour period, and it is 1 859.41.

Men RMR = (9.99 X weight in kg) + (6.25 X height in cm) – (4.92 X age) + 5
= (9.99 x 100) + (6.25 x 177.8) - (4.92 x 52) + 5
= 999 + 1 111.25 - 255.84 + 5
= 1 859.41 kcal/day

Thermic effect of food (TEF) is the energy that the body uses for digestion and
absorption of nutrients. It averages 10% of the energy in the food. It is necessary to
monitor food intake 24 hours to calculate TEF. Mr. X’s TEF is 340 kcal.

TEF = kcal x 10 %
= 3 400 x 10 %
= 340 kcal
Physical activity energy cost (kcal) is daily energy requirement. Mr. X is having a
sedentary lifestyle and his PAL factor is 1.4 - 1.5.

Physical activity energy cost (kcal) = BMR x PAL Factor

= 1 856. 25 x 1.4 - 1.5
= 2 598.75 - 2 784.37 kcal

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Total energy output (kcal) is the amount of energy you expend every day including
not only the calories you burn during physical activity, but also the calories you burn
while at rest (basal metabolism), the calories you burn when you digest food and
heat production (minor). Mr. X’s total energy output is 2 938.75 kcal/24h

Total energy output (kcal) = BMR x PAL + TEF

= 1 856.25 x 1.4 + 340
= 2 598.75 + 340
= 2 938. 75 kcal/24h

Body Mass Index (BMI) is body fat based on the height and weight of an individual.
Mr. X’s BMI is 31.6%

Body Mass Index (BMI) = težina ÷ (visina ÷ 100)²

= 100 ÷ (177.8 ÷ 100)²
= 100 ÷ 1 778²
=31.6 %

Strosar, 2023.

Type 2 Diabetes

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Mayo clinic staff wrote (2023.) Type 2 diabetes is a condition that happens because
of a problem in the way the body regulates and uses sugar as a fuel. That sugar also
is called glucose. This long-term condition results in too much sugar circulating in
the blood. Eventually, high blood sugar levels can lead to disorders of the circulatory,
nervous and immune systems.

Hypertension

Thomas, M.D. (2022.) writes about high blood pressure and he said it is a common
condition that affects the body's arteries. It's also called hypertension. If you have
high blood pressure, the force of the blood pushing against the artery walls is
consistently too high. The heart has to work harder to pump blood.

Blood pressure is measured in millimeters of mercury (mm Hg). In general,

hypertension is a blood pressure reading of 130/80 millimeters of mercury (mm Hg)
or higher.
● Normal blood pressure. Blood pressure is 120/80 mm Hg or lower.

● Elevated blood pressure. The top number ranges from 120 to 129 mm Hg and
the bottom number is below, not above, 80 mm Hg.

● Stage 1 hypertension. The top number ranges from 130 to 139 mm Hg or the
bottom number is between 80 and 89 mm Hg.

● Stage 2 hypertension. The top number is 140 mm Hg or higher or the bottom

number is 90 mm Hg or higher.

Sluggish digestive system

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Watson, (2023.) talks about lazy bowel syndrome, also called sluggish bowel and
slow gut. This is a condition with symptoms of constipation and painful bowel
movements. Some people use “lazy bowel syndrome” particularly to describe the
way your intestines behave after the frequent use of laxatives. When you have this
condition, your colon is slow to move waste through your body’s digestive tract.
Lazy bowel syndrome can be chronic, with symptoms that are present fairly often if
not always. But lifestyle changes and dietary modifications can help improve the
symptoms.

Macronutrients

Carbohydrates, proteins and fats are integral parts of food. Speed of blood sugar
rises, It depends on the type and amount of food consumed.
The proportion of
● carbohydrates is 45-60 %
● protein 12-20 %
● fat ≤35 %
in the total daily energy intake.

Preference should be given to carbohydrates from fruits, vegetables, whole grains,

legumes and milk with a reduced percentage of milk fat.
High-quality proteins that are good to digest and provide all nine essential amino
acids needed to function organisms (meat, poultry, fish, eggs and cheese) and
unsaturated fatty acids from vegetable oils, seeds, nuts and blue fish.
Fiber from fruits, vegetables, cereal seeds and legumes play a major role in the
prevention of diabetes, heart disease and constipation considering that Mr. X already
has health problems such as Type 2 Diabetes, Hypertension and sluggish digestive
system. Intake of these fibers will help the body to control diseases and prevent the
occurrence of major damage. Fiber will also help in moving the bowel, reduce
glucose absorption in the gastrointestinal tract, which lowers blood glucose and the
need for insulin.
Glycaemic Index (GI)

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When choosing food, Mr. X must pay attention to foods with a low glycaemic index,
because they increase insulin sensitivity, help control diseases, reduce hunger and
prolong the feeling of satiety, and also reduce the risk of heart diseases.

Recommendations

Recommendation for Mr. X are:

● limit the intake of salt and sugar

● sugar is not completely excluded from the diet, but it must not be more than
5% of the total energy intake and must be part of a complex meal.
● consume a maximum of 6 g of salt per day
● Carbohydrates should provide 45-60 %, fats ≲35%, and proteins 12-20% of total
daily energy
● drink no more than 6 pints of beer a week with food
● drink no less than 3L water per day
● consume as much omega-3 fatty acids as possible
● a diet rich in fruit and vegetables
● regular physical activity
● reducing body weight and maintaining an ideal body weight
● the food must be weighed

Food groups

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Bread & substitutes
(1 unit contains 15 g of carbohydrates + 3 g of protein; 73 kcal)
1 unit contains:
white/semi-white bread 25 g, black/rye bread and pastries 30 g, graham bread and
pastries 35 g, cornbread 35 g,
potatoes 100 g, rice (white or integral) 20 g, sweet potato 60 g,
pasta (white or wholemeal such as macaroni, spaghetti, etc.) 20 g
beans, peas, corn, lentils, chickpeas 30 g
barley porridge, buckwheat, oatmeal 25 g
corn grits, wheat grits 20 g.

Vegetables
(1 unit contains 5 g of carbohydrates + 2 g of protein; 25 kcal)
1 unit contains:
fresh vegetables (such as lettuce, chard, kale, spinach, broccoli, brussels sprouts,
cauliflower, tomatoes,
beets, cucumbers, zucchini, peppers, mushrooms) 100 g
frozen vegetables 100 g
tomato concentrate 60 g.

Fruit
(1 unit contains 15 g of carbohydrates; 60 kcal
1 unit contains:
banana, fig 80 g
grapes, pomegranate, mango, cherries 90g
pear, kiwi, currant, blueberry 100 g
nectarines, pineapples, tangerines, raspberries 120g
apple, orange, plums, cherries 130 g
peach, apricot, melon, blackberry, papaya 140 g
strawberries, watermelon, grapefruit 190 g
jam from various fruits without sugar 23 g
squeezed fruit juice 120 ml.

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Milk and substitutes
(1 unit contains 12 g of carbohydrates + 8 g of protein + 1.2 - 3.8 g of fat; 91-114
kcal)
1 unit contains:
milk 1.5% fat 240 g
fermented milk products (yogurt with probiotics 1.5% m.m., kefir) 240 g

Meat and substitutes

(1 unit contains 7 g of protein + 1-8 g of fat; 45-100 kcal)
1 unit contains:
meat 30 g (chicken, turkey, beef, veal, beef, lamb, pork (thigh), game)
sea and river fish 30 g
canned fish (tuna, sardines, etc.) 30 g
fresh cow's cheese 60 g
cheese spread up to 30% m.m. 30 g
turkey ham delicacy, ham toast, chicken breast in a wrapper 50 g
chicken egg 65g.

Fats and substitutes

(1 unit contains 5 g of fat; 45 kcal)
1 unit contains:
oil (such as pumpkin, olive, sunflower, rapeseed, soybean, corn germ, linseed,
soybean) 5 g
butter 5 g
milk spread up to 75% m.m. 20 years
olive 45 g
almonds 6 pcs
walnut 4 halves
hazelnut 5 pcs
pumpkin, sesame, flax, sunflower seeds 8 g

One day menu plan

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Breakfast - 1 cup oat, 200ml skimmed milk, ½ grated apple, 2 tbsp mix nuts, 1 tsp
cinnamon
Mid morning snack - 3 slices whole grain french toast, 1 orange
Lunch -1 serving of tomato soup, 1 hake filet, 1 serving mixed salad (tomato,
lettuce, cucumber), 1 cup of beans with pumpkin seed oil
Mid afternoon snack - 1 apple, 1 cup of tea with 1 tsp of stevia sugar
Dinner - 1 grilled chicken filet, 100g boiled mixed vegetables and 100 g boiled
potatoes seasoned with olive oil, 2 slices of brown bread.
Water consumption - 3.3 liters during the day

Hydration

Water requirements
= kg x 0.033
= 100 x 0.033
= 3.3 L/day

Conclusion

Mr. X’s body mass index is 31.6 % which shows that he is obese. Such a condition
immediately puts him in the risk group for cardiovascular risk disease (complications
on large blood vessels) such as heart attack and stroke and nephropathy,
retinopathy and neuropathy diseases that cause complications on small blood
vessels. He can avoid that by changing his life habits. Since he already suffers from
hypertension, the change will help him avoid kidney disease in the future.
Mr. X must lose a minimum of 21 kg, and his ideal weight would be between 58.6kg
- 79.2kg. His total calorie intake is 3 400 kcal and it should be 1 500 kcal - 1 800
kcal. Mr. X must consume at least 130g of carbohydrates, recommendations for
dietary fiber intake is between 25g - 35g, sugar should not be more than 5% of the
total energy intake and at least two servings of fish should be consumed weekly.

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Food must be weighed at the beginning to get used to how much food should be on
the plate. Omitting one of the food groups (carbohydrates, proteins, fats) sugar
regulation will not be satisfied.

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References:

● https://hanstrom.com/blog/calories-in-coffee/#How-many-calories-are-in-a-
cappuccino
● https://www.fatsecret.com/calories-nutrition/usda/green-peas?
portionid=34344&portionamount=1.000
● https://www.google.com/search?
q=1%2F2+cup+gravy+calories&rlz=1CAGZLV_enHR1019HR1019&oq=gravy
+1%2F2+cup+&aqs=chrome.3.69i57j0i22i30j0i15i22i30j0i22i30l7.15230j0j7&s
ourceid=chrome&ie=UTF-8
● https://www.google.com/search?
q=1+packet+of+crisps+calories&rlz=1CAGZLV_enHR1019HR1019&oq=crisp
s+1+packet+cal&aqs=chrome.2.69i57j0i22i30l2.13535j0j7&sourceid=chrome
&ie=UTF-8
● https://www.google.com/search?
q=coleslav+kcal&rlz=1CAGZLV_enHR1019HR1019&oq=coleslav+kcal&aqs=
chrome..69i57j0i13i512j0i13i30l3j0i5i13i30j0i8i13i30l2j0i8i13i15i30l2.8670j0j7
&sourceid=chrome&ie=UTF-8
● https://www.google.com/search?
q=dairy+milk+bar+kcal&rlz=1CAGZLV_enHR1019HR1019&oq=dairy+milk+ba
r+kcal&aqs=chrome..69i57j0i22i30l9.16105j0j7&sourceid=chrome&ie=UTF-8

● https://www.google.com/search?
q=kcal+in+bacon+per+slice&rlz=1CAGZLV_enHR1019HR1019&oq=kcal+in+
bacon+per+slice&aqs=chrome..69i57j0i22i30l2.13689j0j7&sourceid=chrome&
ie=UTF-8
● https://www.google.com/search?
q=mashed+potatoes+kcal&sca_esv=570134643&rlz=1CAGZLV_enHR1019H
R1019&sxsrf=AM9HkKmaaSjCZRig75pcryjYXT6Qma1jMQ
%3A1696278155923&ei=iyYbZYbxN--
WhbIPi_a14AY&ved=0ahUKEwjG4rHHmNiBAxVvS0EAHQt7DWwQ4dUDCB
A&uact=5&oq=mashed+potatoes+kcal&gs_lp=Egxnd3Mtd2l6LXNlcnAiFG1hc
2hlZCBwb3RhdG9lcyBrY2FsMggQABjLARiABDIGEAAYCBgeMgYQABgIGB

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 5IoCJQjghYsxlwAXgBkAEAmAFZoAGJBKoBATe4AQPIAQD4AQHCAgoQAB
hHGNYEGLADwgIKEAAYigUYsAMYQ8ICBxAjGLACGCfCAgYQABgHGB7C
AgcQABgNGIAEwgIIEAAYCBgHGB7CAgYQABgeGA3CAggQABgFGB4YDcI
CChAAGAgYBxgeGA_CAggQABgHGB4YE8ICChAAGAgYBxgeGBPCAgwQ
ABgIGAcYHhgPGBPiAwQYACBBiAYBkAYK&sclient=gws-wiz-serp

● https://www.healthline.com/health/lazy-bowel
● https://www.healthline.com/nutrition/croissant-calories#calories
● https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/
symptoms-causes/syc-20373410
● https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-
causes/syc-20351193
● https://www.nutracheck.co.uk/calories/calories_in_biscuits/
calories_in_biscuits_digestives
● https://www.taste.com.au/healthy/articles/calories-food-list/xgns0z78
● https://www.taste.com.au/healthy/articles/calories-meat-poultry-other-
favourite-proteins/9oot7asq
● https://www.weightlossresources.co.uk/calories-in-food/beef/sirloin-steak.htm

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