Question

Matt is 34 years old. His BMI is 28 and has steadily increased over the last few years when he accepted a position with his company that requires frequent travel. It is hard for him to exercise, and he eats out often. He is a "steak and potatoes" kind of guy who wouldn't dream of eating lunch or dinner without meat as the centerpiece of the meal. At his most recent annual employee physical, Matt's total cholesterol level was 245 mg/dL, his HDL level was 50, fasting glucose level was 92, and his blood pressure was 154/85 mmHg. His father died of a heart attack at age 49 years. Matt feels doomed by genetics and is resistant to going on medication because of the potential side effects. He is willing to try to change his diet and lifestyle but is skeptical that it will help. • What risks does Matt have for heart disease? • Knowing that he is willing to change his diet and lifestyle, what additional information would you ask of Matt before devising a teaching plan? • What diet recommendations would you prioritize in helping Matt initiate a healthy eating pattern? What suggestions could you offer him to help him meet these recommendations? • How would you respond to Matt's skepticism that lifestyle factors will probably not lower his risk of heart disease?

Answer 1

Matt's Risk factors for HEART DISEASE

• INCREASED BODY MASS INDEX, which directly shows that he is OVERWEIGHT. (Normal BMI ranges from 18.5 - 24.9Kg/m2, where his BMI is 28 that means he is OVERWEIGHT)
• PHYSICAL INACTIVITY
• SEDENTARY LIFESTYLE
• UNHEALTHY DIETARY PATTERN
• HIGH TOTAL CHOLESTEROL LEVEL ( Normal total cholesterol level should be <170mg/dL, where his total cholesterol level is 245mg/dL)
• HIGH BLOOD PRESSURE ( Normal bkobl pressure is 120/80mm of Hg, where his BP is 154/85mm of Hg)
• HEREDITY (Matt's father died at 49yrs due to HEART ATTACK)

ADDITIONAL INFORMATIONS TO BE COLLECTED

1. ​​​​​​​WAIST CIRCUMFERENCE, which reflects abdominal fat accumulation and it is a strong indicator for CAD, STROKE
2. LIKES & DISLIKED TOWARDS FOOD ITEMS
3. CULTURAL BELIEFS
4. DAILY ROUTINE OF MATT

​​​​​​​DIET RECOMMENDATION

​​​​​​​Matt has to follow HEART HEALTHY DIET to improve blood pressure and cholesterol and to reduce risk of type 2 diabetes. A HEART HEALTHY DIET PLAN INCLUDES:

1. VEGETABLES AND FRUITS
2. BEANS OR OTHER LEGUMES
3. LEAN MEATS AND FISH
4. LOW FAT OR FAT FREE DAIRY FOODS
5. WHOLE GRAINS
6. HELATHY FATS, SUCH AS OLIVE OIL

​​​​​​​Two examples of HEART HEALTHY DIET PLAN ARE DIETARY APPROCHES TO STOP HYPERTENSION (DASH DIET) & MEDITERRANEAN DIET.

Limit the intake of:

• Salt
• Sugar
• Processed carbohydrates
• Alcohol
• ​​​​​​​Saturated fat and trans fat

Answer 2

Risk factor of Heart Disease Matt has; High cholesterol Family history Age Poor diet Physical Inactivity Diet is an important risk factor in coronary heart disease. Heart disease occurs when plaque develops in the arteries and blood vessels that lead to the heart. This blocks important nutrients and oxygen from reaching your heart. Plaque is a waxy substance made up of cholesterol, fatty molecules, and minerals. Plaque accumulates over time when the inner lining of an artery is damaged by high blood pressure, cigarette smoking, or elevated cholesterol or triglycerides. I would ask for what time he is free from work to direct the scheduling of doing exercises and what type of food available to advise what he suppose to eat. A healthy diet and lifestyle are the keys to preventing and managing cardiovascular disease. Below are the steps that part of your life for long-term benefits to your health and your heart. Adjust energy intake and expenditure to achieve and maintain a healthy body weight. Eat plenty and a variety of fruits and vegetables. Choose whole grain foods and products. Choose healthy sources of protein: mostly plants, a regular intake of fish and seafood, and low-fat or fat-free dairy products. If meat or poultry is desired, choose lean cuts and unprocessed forms. Use liquid plant oils rather than tropical oils, such as coconut and palm, and partially hydrogenated fats. Choose minimally processed foods instead of ultra-processed foods. Minimize the intake of beverages and foods with added sugars. Choose and prepare foods with little or no salt.