Develop Menus High Blood Pressure and Heart Rate

Question: Discuss about theDevelop Menusfor High Blood Pressure and Heart Rate. Answer: Introduction The patient, Mr. Giles, a 61-year-old male was admitted to a hospital with high blood pressure and heart rate. He had cholesterol and had a habit of smoking. Hence suffered a stroke and as a result had short-term memory loss. He had been under control since the last 14 months. However, he was overweight, had stomach problems, lack of energy, irritability and developed rashes on legs, occasionally. Due to the obesity, he was unable to walk without a walking stick and suffered from mild depression. He was admitted to a hospital, undergone some blood test and was detected with type 2 diabetes. The allergy test detected that the patient was allergic to nuts, raw tomatoes, garlic and nuts. Moreover, he was intolerant to wheat/gluten (Ceoliac) and lactose. 14-day menu that takes into account all allergies and intolerances the patient (Mr Giles) has. The menu and recipes must consist of the follow categories: Table 1: Menu Recipes Breakfast cup of high fibre breakfast cereal with low fat lactose free milk or 2 bread slices, toast (made of whole grain other than wheat) with avagado or margarine, grilled tomato, baked beans, 1 fruit (other than strawberry), tea or coffee. Lunch 1 /2 to 1 cup of pasta or cooked rice or two small potatoes. Other vegetables can be added as per requirement. 65 to 80 grams of lean meat, seafood, skinless poultry, egg or legumes like beans (1 cup cooked). 1 fruit (other than strawberry), tea, water or coffee. Dinner 1 bread slices (gluten free) served with margarine, or fat free mayonnaise made from lactose free milk. Vegetable salads (other than raw tomatoes). 65 to 80 grams of lean meat, or 100 grams of fish or seafood, skinless poultry, egg or legumes like beans (1 cup cooked). 1 fruit (other than strawberry), tea, coffee or water. With a choice at each meal period 1 fruit (other than strawberry) 1 cup lactose free yoghurt, 1 slice bread (gluten free, made of grain other than wheat), high fibre crispy breads or crackers. Table 2: Week 1 Menu Plan Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Breakfast 2 bread slices + low fat lactose free milk+ tea Toast with thinly spread margarine+ baked beans+ 1 fruit +tea Low fat lactose free milk+ 2 bread slices+ coffee+ 1 fruit Toast+ grilled tomatoes +tea+ 1 fruit 2 bread slices + low fat lactose free milk+ tea Toast with thinly spread margarine+ baked beans+ 1 fruit +tea Low fat lactose free milk+ 2 bread slices+ coffee+ 1 fruit Lunch 1 bread roll+ vegetables+ 1 egg+ 1 fruit + coffee 2 bread slices+ vegetable+ seafood+ low fat lactose free yoghurt+ tea 1 cup cooked pasta+ vegetables+ lean meat+ fatless lactose free custard 1 cup sweet corn+ egg+ vegetables+ beans+ low fat lactose free yoghurt+ coffee 2 medium potatoes+ vegetable+ legumes+ 1 fruit+ tea 1 cup sweet potato+ vegetable+ lentils+ custard 1 cup cooked rice+ skinless poultry+ vegetables + fat reduced cheese+ 1 fruit+ tea Dinner 1 sandwich (2 bread slices) with thinly spread margarine+ vegetables for salad+ skinless poultry+ 1 fruit+ tea 1 bread roll with avocado+ salad vegetable+ fat reduced cheese+ 1 fruit+ coffee 4 bread biscuits+ vegetable+ lean meat+ 1 fruit+ tea 2 bread slices with thinly spread margarine+ vegetable for salad+ beans+ tea 1 sandwich (2 bread slices) with thinly spread margarine+ vegetables for salad+ seafood+ 1 fruit+ tea 1 bread roll with fat free mayonnaise+ salad vegetable+ egg+ 1 fruit+ coffee 4 bread biscuits+ vegetable+ legumes+ 1 fruit+ coffee With a choice at each meal period 2 high fibre crisp breads 1 cup low fat lactose free milk 2 high fibre crackers 1 slice fruit bread 1 cup of low fat lactose free yoghurt 1 fruit 1 slice of bread (gluten free) Table 3: Week 2 Menu Plan Day 8 Day 9 Day 10 Day 11 Day 12 Day 13 Day 14 Breakfast Toast with thinly spread margarine+ baked beans+ 1 fruit +tea Baked beans+ toast with thinly spread jam +1 fruit+ coffee Low fat lactose free milk+ 2 bread slices+ coffee+ 1 fruit Toast+ grilled tomatoes +tea+ 1 fruit Toast with thinly spread margarine+ baked beans+ 1 fruit +tea Baked beans+ toast with thinly spread jam +1 fruit+ coffee Low fat lactose free milk+ 2 bread slices+ coffee+ 1 fruit Lunch 1 cup cooked pasta+ vegetables+ lean meat+ fatless lactose free yoghurt 1 cup sweet corn+ egg+ vegetables+ beans+ custard+ fruit 2 medium potatoes+ vegetable+ lentils+ 1 fruit+ tea 2 bread slices+ vegetable+ seafood+ low fat lactose free yoghurt+ tea 1 cup cooked rice+ skinless poultry+ vegetables + fat reduced cheese+ 1 fruit 1 bread roll+ vegetables+ 1 egg+ 1 fruit + coffee 1 cup sweet potato+ vegetable+ lentils+ low fat yoghurt+ coffee Dinner 1 bread roll with avocado+ salad vegetable+ legumes+ 1 fruit+ coffee 4 bread biscuits+ vegetable salad+ egg+ 1 fruit+ tea 2 bread slices with thinly spread margarine+ vegetable for salad+ seafood+ tea 4 bread biscuits+ vegetable salads+ lentils+ 1 fruit+ coffee 1 sandwich (2 bread slices) with thinly spread fat free mayonnaise+ vegetables for salad+ skinless poultry+ 1 fruit+ coffee 2 bread slices with thinly spread avocado+ vegetable for salad+ lean meat+ tea 4 bread biscuits+ vegetable salads+ skinless poultry+ 1 fruit+ tea With a choice at each meal period 1 fruit 1 cup of low fat lactose free yoghurt 1 slice of bread (gluten free) 2 high fibre crisp breads 1 cup low fat lactose free milk 1 slice fruit bread 2 high fibre crackers In compiling the menu, several issues or constraints due to the establishment have been highlighted: Giles diet plan has been planned in accordance to the allergies and intolerances he was detected with in the blood test. He was allergic to nuts, garlic, raw tomatoes and strawberries. In the diet plan, baked or grilled tomatoes have replaced the raw tomatoes. Raw tomatoes are excluded from the vegetables in the salad or as side dishes. Among fruits, all fruits are included other than strawberries as the patient is allergic to strawberries The spread on the bread in the breakfast, dinner or between meals are devoid of peanut butter or any nuts and replaced by avocado. Nuts and garlic are not included in the diet as the patient is allergic to them. Gluten free breads are recommended in the diet plan, as the patient is intolerant to wheat/gluten. The patient is intolerant to lactose; hence, lactose free milk and yoghurt have been included in the diet plan. The choice of ingredients and the dishes have been analyzed and the dishes are considered to be suitable and in compliance with the dietary restrictions. The meal is planned for a 61 year old, male patient with diabetes such that- the size of the servings are appropriate for him, the meals are spread uniformly, they are capable of providing balanced diet, the meal panned has low content of fat, specifically saturated fat. The diet plan is containing high fiber carbohydrates like cereals, breads, beans, vegetables and fruits. As per the instructions by the dietician, the dishes must have the fat content of less than 2% o free from cholesterol. Hence, the diet has been planned following the dieticians instructions. Moreover, the patient as found to be gaining weight as well as had high cholesterol issues. Moreover, the patient had low energy levels. Hence, the patient was in high requirement of diet with good fats. The fats are the sources of energy found in all food items. Nevertheless, the type and quantity of fat intake is vital for maintaining a healthy life. However, consuming high amount of fat may lead to gaining of weight. It will also contribute to increasing the blood glucose level making the patient severely ill. Hence, the diet has been planned with small amounts of fat, which will impart good taste to the food as well as it will also reduce the risk of developing further cardiovascular complications which the patient already encountered two years back. According to the Australian dietary guidelines, the diet needs to be balanced and must contain all the five food groups. The five food groups include: Vegetables and legumes Fruits Wholegrain cereals or high fiber containing cereal food Lean meat, fish, poultry, eggs, nuts, seeds and legumes Reduced fat milk, cheese and yoghurt According to the Australian dietary guidelines, unsaturated fats and oils can be permitted for cooking. Moreover, nuts and seed can also be included in the diet for patients of age less than 70 years, male. The prescribed quantity is 28 to 40 grams per day (diabetesnsw.com.au, 2016). Table 4: Diet plan for 61 year old male as per Australian dietary guidelines Men 51-70 years Vegetables and legumes Fruits Grains (Cereal) Lean meat, fish, poultry, eggs, nuts, seeds and legumes Reduced fat milk, cheese and yoghurt 5.5 2 6 2.5 2.5 The menu that has been framed meets all the 5 food groups in the recommended quantities. The diet that has been planned contains all the items from the food groups like the cereals (breads), vegetables and legumes like beans, tomatoes, fruits, vegetable salads, beverages like tea, coffee or water. The diet also contains lean meat, fish, eggs and seeds. It contains reduced fat milk, cheese and yoghurt. However, the diet does not contain the nuts as per the guidelines as the patient is allergic to nuts and the milk or yoghurt prescribed in the diet plan is lactose free as the patient has intolerant to it (Ramsden et., 2013). The dishes are planned such that the fat management is properly done. Hence, the menu contains baked, grilled, fat free food items as well as the alcohols or such beverages are also limited in the diet plan. Skinless chicken is recommended to reduce the trans fat and saturated fat intake. Fried foods are avoided. The menu limits fats, salts, sugar and alcohol. The menu contains low fat milk, yoghurt and lean meat. Butter, coconut cream or such saturated or trans saturated fat rich food items are not included in the diet plan, the diet plan does not contain any high sugar containing food. However, the diet plans of diabetes may contain sugar, hence, the sugar content in vegetables like potatoes, sweet corn, although their quantity has been limited. The diet plan does not contain any alcohol; however, lite beers can be added as they have less than 3% alcohol content. As a result, it would not contribute to weight gain. The quantity of salt in the diet is also maintained well while planning the diet. The food must be prepared and stored safely for wellbeing of the patient and ensure his speedy recovery. The food must be prepared in a hygienic environment and stored properly such that the food does not get contaminated. Moreover, special attention must be provided as the patient had stomach issues, hence food should be cooked well and easily digestible. The following points have played significant part while planning the diet for the patient: The nutrients and the food sources are carbohydrates (potatoes), fats (reduced fat milk), proteins (fish, meat, eggs). The kind of food planned in the diet chart have possible influences in weight loss, less chances of heart diseases, the diet has been planned as per the patient requirement and allergies. The foods and beverages selected are tea, coffee or water in limited quantity. The food labeling and interpretation were also taken into account for planning the diet. The food additives are not used in the diet to ensure further reactions like rashes or digestion related problems are eliminated. Poor food choices may lead to deterioration of the patient as if the allergens might cause allergic reactions or the lactose might cause rashes in the patient. Consumption of high fat containing food might increase weight and cause heart diseases. However, the diet has been planned considering all the issues. Following good and healthy food habits like the one planned in the diet chart will help avoid dietary diseases like heart diseases, obesity and diabetes. Baked, grilled and boiled foods are the healthy choices of cooking that would ensure proper digestion, weight management and healthy life. The choices of the food in the diet chart are planned as per the patient preferences. This would facilitate active participation in the food related habits that will accelerate the recovery procedure of the patient. The few other things that are to be considered for discussion with the dietician are: Whether the patient was compliant to the previous diet plan. Reason: the compliance of the patient to previous diet will facilitate the treatment procedures. Whether the patient has serious dental problems. Reason: The information on patients dental condition will help in maintaining the texture and consistency of the food. If the patient has dental problems, he might need food that can be chewed easily. This will enhance the ability of the patient to digest the foods easily. Whether the patient has any special dietary requirement like vegetarian diet, religion and belief based diets. Reason: The information and knowledge regarding the special dietary requirements by the patient will help promoting the entire nutrition process and the patient preferences can be accommodated accordingly. References: Ramsden, C. E., Zamora, D., Leelarthaepin, B., Majchrzak-Hong, S. F., Faurot, K. R., Suchindran, C. M., ... Hibbeln, J. R. (2013). Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis.Bmj,346. www.diabetesnsw.com.au,. (2016). Retrieved 27 October 2016, from https://diabetesnsw.com.au/wp-content/uploads/2014/12/DA-15-Food-choices-for-people-with-diabetes.pdf