Nutrition Case Study: Underweight Patient and Diet Plan

This case study examines malnutrition and its impact on health, particularly focusing on an underweight patient with high cholesterol. The paper begins with an executive summary and then defines malnutrition, detailing its prevalence, causes, and types, including wasting, stunting, and micronutrient deficiencies. The study presents a specific case involving a patient with a BMI indicating underweight status, high cholesterol, and a potentially unhealthy lifestyle, including poor dietary habits and smoking. The discussion emphasizes the importance of a balanced diet, recommending increased consumption of fruits, vegetables, grains, and protein while restricting fats and cholesterol. A detailed diet plan is provided, including calorie intake recommendations and specific food choices, such as replacing red meat with chicken and incorporating low-fat dairy and beans. The study also addresses lifestyle factors, such as caffeine, alcohol, and lack of exercise, and offers therapeutic approaches to improve the patient's condition. The paper concludes with a review of the key findings and recommendations for promoting a healthier lifestyle through proper nutrition and lifestyle changes.

Running head: NUTRITION- CASE STUDY
Nutrition- Case Study
Name of the Student
Name of the University
Author Note

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Executive Summary
The below paper discussed about malnutrition and its impact in daily life. Malnutrition leads
to many chronic diseases like heart disease, diabetes type 2. There are four types of
malnutrition. The paper also discusses about a case study where the client is underweight,
which is identified by body mass index. The patient also suffers from high cholesterol and
due to defective lifestyle. Proper balanced diet is essential in maintaining the condition. There
are several barriers in approaching the therapy for patients. Lastly, the paper discusses about
the diet plan based upon the case study.

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Table of Contents
Introduction................................................................................................................................3
Discussion..................................................................................................................................4
Definition...............................................................................................................................4
Prevalence..............................................................................................................................5
Causes of malnutrition...........................................................................................................6
Diet.........................................................................................................................................7
Diet plan for the client............................................................................................................8
Lifestyle..................................................................................................................................9
Lifestyle factors that influence health................................................................................9
Lifestyle recommendation, eating and behaviour..............................................................9
Therapeutic approach...........................................................................................................10
Conclusion................................................................................................................................11
References................................................................................................................................12

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Introduction
Nutrition or healthy nutrition is an essential part of life, which helps in leading a
healthy lifestyle. It is combined with both physical activities and diet, leading to maintain a
healthy weight (Leslie and Hankey 2015). It helps in the prevention of many diseases,
especially heart disease and cancer, contributing good health overall. It can be demarcated as
a progression, by which the organism’s ingestion, digestion, absorption, transportation of
nutrients takes place, and the product is deposited. Food is an essential component that is
used as a fuel; there are different types of food such as energy giving food, bodybuilding
food, protective foods and regulatory food (Thomas 2018). The nutritional disorder is
harmful to human life, severally affecting life. These disorders include obesity, underweight
condition, anaemia, cardiovascular diseases, cancer, diabetes, gastrointestinal disorders and
many more (Crimmins 2015). Nutritional deficiency happens when the body fails to absorb
nutrients incorrect amount for maintaining the physiological functions of the body. The
deficiency may lead to skin problems, defective muscular disorder, high cholesterol and even
psychological disorder. The deficiency also affects the development of the body’s immune
system. It also influences the development of infectious diseases, enhancing bacterial growth
and systemic infectious diseases. Malnutrition or malfunctioning of the body is the weakened
metabolism of the body due to prolonged deficiency or excess consumption of energy-related
food. It includes protein, fatty acids and vitamins. There are several symptoms of this
condition, like impaired digestion, malabsorption and loss of appetite (Krzyminska-Siemazko
et al. 2016). There are four types of malnutrition that are broadly classified like wasting,
underweight, stunting and deficiency of micronutrients. The main purpose of the below paper
is to identify the malnutrition disorder based upon a case study and to suggest an effective
lifestyle in reducing the condition and leading a healthy life.

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Discussion
Definition
Malnutrition defines as a deficiencies or imbalance of nutrients uptake of the body
(Bharadwaj et al. 2016). It includes many forms of nutritional disorders like wasting,
underweight and stunting. It is caused due to inadequate intake of vitamins, minerals causing
obesity and overweight and also relating to noncommunicable disease. The various forms of
under nutritional disorder are wasting, stunting, deficiency in vitamins and mineral and
underweight. The process of height for low weight is called wasting (Uauy, Garmendia and
Corvalan 2014). It is referred to as current and extreme weight loss because the person is not
adequately consuming food or is having an infectious disease such as diarrhoea, generally
caused due to loss of weight. It may also lead to the risk of death in patients who has
moderately or relentlessly wasted condition. The process of age and low height is called
stunting. It is generally associated with low or poor socio-economic state resulting in this
condition. The common outcomes of this state are infertility in women, chronic or frequent
illness and many more. Stunting in infants or in children retards in height and also faces
defective physical appearance along with a low level of cognitive thinking (Hoffman, Bigoni
and Carrieri 2019).
Inappropriate consumption of vitamins and minerals, also known as micronutrients
enables the body to produce enzymes, enhancement of growth and development, production
of hormones. Vitamin A, iron and iodine are the most important deficiency that is a major
health concern all over the world, especially in low-income countries and families (Burke,
Leon and Suchdev 2014). Overweight and obesity occurs in the human body due to the
consumption of an excessive amount of fats leading to its accumulation in the body and also
impairing the health. The overweight condition or obesity can be measured by calculating the

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body mass index. It is generally calculated by weight divided by height in meters square
(Nuttall 2015). Overweight or obesity can cause an imbalance between energy spent and
energy consumed. Currently, in the world, the consumptions of high energy-related food
along with high-fat content is more along with a low level of physical activities, which causes
many health hazards. Non-communicable diseases that are related to diet causes many
diseases such as cardiovascular disease rises mainly due to high blood pressure and poor
metabolism. It also leads to a high amount of type 2 diabetes and cancer (Gallaghar and
LeRoith 2015).
Prevalence
The prevalence of this malnutrition is calculated or measured by the presence of this
disease in a sample that is randomly nominated and then dividing that selected population by
the help of people who are suffering from that particular condition. It is expressed in terms of
calculation. The result of stunting condition that is generally found is 16.2%, and that of
underweight is found to be 43.1% (Abdullah 2015). The percentage of underweight condition
throughout the world is 24.8%. The World Health Organization defined the wasting, stunting
and underweight as Z-scores that are lower than -2 in standard deviations of several factors,
like weight, height, the age for height and also weight for age (Hashim 2016). These refer to
the acute reflection of chronic experiences of nutritional deficiency, whereas underweight
condition reflects both the acute and chronic state of this disease. Older adults are more
disposed to malnutrition condition due to the fact that ageing factor accumulates impairment
of diseases. If may also cause depressive symptoms, a variety of emotional state and physical
impairment condition. There is a poor condition that is related to this condition like a
deficiency in metabolism, defective distribution of nutrients in the body, problems in
excretion, alteration of the drug nutrition relationship and also excretion. The rate is
progressively high all over the world, such as 35-65% in adults who are admitted hospitals,

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25- 60% in geriatric care of the hospital. The predicated rate in the upcoming year is expected
to increase in 2050. The population above the age of 80years will expect to have 11.5 to 21%
malnutrition condition. This condition is also prominent among the children; the analysis of
the state reveals that 21.9% of children have stunted growth (Favoro-Moreira et al 2016).
Lack of nutrition or poor nutrition also termed as undernourished leads to the death of the
children.
Causes of malnutrition
Malnutrition is a cause when the consumption of food or nutrition is limited, resulting
in a variety of complications in the body. There are several problems that are associated with
this condition, and these are long and short term health issues, delay in recovering of the
chronic disease, having a high risk of infection along with triggering of several mental
disorders. Lack of vitamin is also common among the patients suffering from malnutrition,
which causes scurvy, the population, or individual having a tendency of consuming alcohol
are more prone to the risk of this disease (Burke, Leon and Suchdev 2014). There are several
symptoms and signs that indicate the condition of malnutrition; these are lack of appetite,
irritability along with tiredness of the body, lack of concentration in work, temperature
elevation of the body, anxiety, depression. Other physiological chances are fat accumulations,
muscles loss, and also body tissue impairment. It also increases the rate of complications after
surgery and also takes a long time to heal any disorders (Loser 2014). In children, the main
condition that is observed is the decrease in body weight and also stunted growth. This
condition also leads to mental and psychological issues like anxiety, anorexia nervosa.
There are various causes of this disease; the primary purpose is the inability in the
absorption of food or lack of availability of food. Another cause can be lack of physical
exercise. All these can result in liver disease, cancer, difficulty in swallowing, along with

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nausea. There are many social problems as well for the development of this disease, difficulty
or lack of time in buying proper food, physical exertion in preparing meals and many more.
Other complications that may arise due to this malnutrition are ulcerative colitis, celiac
disease, persistent diarrhoea and Cohn’s disease. Consumption of alcohol can lead to long
term gastric disorders which results in difficulty in the absorption of food and also the
regulation of metabolism (Lukaski, Kyle and Kondrup 2017). The condition can be identified
by blood testing for general screening of the disease, tests to identify specific nutrients that
are causing the malnutrition, identifying the albumin for protein malnutrition along with an
indication of the liver and kidney disorder. There is a specific tool for the identification of
this risk factor named malnutrition universal screening tool. It consists of following step in
the determination of the fact these are a calculation of body mass index, identification of
score of weight loss, determination of the physical condition and mental condition and finally
identification of score along with risk factors.
Diet
The given case study discussed a patient is suffering from malnutrition, especially
underweight condition along with the high level of cholesterol. The body mass index that is
found for this patient is 15.6, which is severely underweight condition. The normal range of
BMI is 18.5- 24.9 in adults. The level of high-density lipoprotein is average, and the total
cholesterol level is found to be very high. The patient is also having a risk of high blood
pressure, which may cause heart disease. The cause of having this condition might be
irregular food intake and a high level of caffeine, along with having alcohol. The patient also
has a history of a high level of smoking. The patient lacks physical exercise, and the diet
mainly constitutes fat food. The balanced diet is highly recommendable for gaining weight
and to maintain a healthy lifestyle. The foods that are highly recommendable are fruits,
vegetables, grains (Roy 2014). Having more amount of protein is also essential for this

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purpose. Fat and cholesterol-rich food must be restricted for this purpose as the patient is
having a high level of cholesterol. Beans and nuts can be helpful for this purpose as a fibre
containing food. Fat-free milk is also essential for this purpose. The patient has a history of
consuming alcohol which makes the body dehydrated acquiring more water from all the body
part leading to a condition of high cholesterol. The dietary management must include an
adequate quantity of water (United Kingdom 2020).
Diet plan for the client
The patient is consuming more amount of fat like meat, thick butter spread, ham and
beef. The diet must include more amounts of vegetables and also a high quantity of protein
(United Kingdom 2020). The diet must include more amount of fruits and vegetables, like
salads at breakfast. The whole grain contains must also be increased in this case; however,
spelt, teff, bulgar can be included in the diet. The calorie intake for the patient must be
1642kcal. The portion must be restricted in red meat, which the client consumes on a daily
basis. It must be replaced by chicken which is low fat and also helpful in gaining weight
(Nusbaum et al 2014). The alternative dairy products which are of low fat and low sugar
must be included in the diet. More amount of beans, pulses are also recommended for this
case. Oils and fats must be restricted in spite of that vegetable oils can be taken into a daily
basis. Daily consumption of water must be increased, which will be helpful in keeping the
body dehydrated. The proportion of 5 food guide must be the incorrect portion (Nusbaum et
al 2014).. Five portions of a variety of fruits and vegetates must be included, whole grains
must be chosen, restriction of alcohols must be done, oily food must be avoided, and daily
fluid must be taken.

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Lifestyle
Lifestyle factors that influence health
The mode of lifestyle affects health severely. The condition that occurs due to this is
malnutrition, consumption of drug, alcohol and unhealthy diet dominant the lifestyle
(Lambert et al. 2017). The factors that promote a healthy lifestyle are maintaining a healthy
diet, maintaining or keeping a healthy body weight, keeping a regular track or maintaining
daily physical activities, reducing the smoking habit and also reducing the alcohol
consumption. In this case, the client is mainly affected by this condition due to defective
lifestyle choose. She is having limited physical activities, which is promoting a high level of
fat in the body; the patient also has a history of smoking which can be the cause of
underweight (Amarya, Singh and Sabharwal 2015). The change in the behaviour must be
taken into account for reversing the present condition.
Lifestyle recommendation, eating and behaviour
A healthy lifestyle is usually achieved by maintaining a proper lifestyle. Proper
lifestyle includes adequate consumption of balanced diet maintain a proper exercise. It helps
in the management of stress and managing a healthy weight. There are many barriers in
having a proper lifestyle; these are flexible time in maintaining the diet and activities, daily
habits, consequences of the habits, having poor knowledge about the condition that the
patient is undergoing, lack of social support, anxiety and finally depression (Boulos, Salameh
and Barberger 2017).
The common barriers that the client in having for achieving a healthy diet is lack of
physical activities and imbalance of diet (Eide, Halvorsen and Almendingen 2015). The client
must be advised to have a daily exercise for boosting up more energy of the body,
maintaining a good strength of bones and muscles, reducing the high level of cholesterol. It

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will also be beneficial in reducing chronic health disease and enhancing healthy memory. The
patient can be advised in involving with various social activities like yoga, restrained strength
aerobic physical actions, light walking and light cycling.
The eating habits that must be included for the client is more proportion of vegetables,
especially fibre foods. More amount of fruits, less amount of fat-containing food and
consuming more amount of water. This will also include a high amount of minerals that are
essential for maintaining micronutrients of the body, strengthening the bones and muscles.
Therapeutic approach
There are several kinds of behavioural approach that is associated with providing
strategies in advising nutrition and maintaining a healthy life. To address an individual
regarding any behaviour strategies are to deliver evidence based service, explaining the
harmful effects about the habits that the client is undergoing, the plan must provide proper
knowledge about the disease to the patient. The intrinsic psychological elements mainly
comprise of personality, cognition and emotion, changing the must first address the cognitive
thinking of the patient bringing about the motivation to adopt the change (Ryan and Deci
2017). The theory of planned behaviour suggests that the behaviour of a certain person can be
identified by the intention of performing the action by that person. The intentions are
attitudes, subjective norms and barriers in controlling behaviours. Another theory is the
transtheoretical model which comprises of few factors like phase of change, a process in
changing, balance in decision and temptation (Prochaska, Redding and Evers 2015). The
approach can be facilitated by pre-contemplation, contemplation, preparation of the plan, the
action of that plan, and finally maintaining the plan. The strategies must include a few steps
that must be followed, such as problem-solving, monitoring the condition, providing social
support, having a self-monitoring planning and rewarding the fact.

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The therapeutic approach is a way of recommending the client in maintaining both
psychodynamic and behavioural changes that need to be taken in addressing the problem. The
client must be provided with ideas and knowledge about the harmful complications of the
situation, which will be helpful in avoiding the condition. The stress management or
emotional, controlling therapy is useful in reducing the stress condition of the client; social
support is important, which will enlighten and build a positive image. The patient must also
be advised for cooking lower level of carbohydrate food.
Conclusion
The above paper discussed the nutritional foods and their benefits in the human body.
The body needs proper amounts of dietary fibres, vitamins, minerals to maintain a proper
function and metabolism of the body. Malnutrition can be caused by a struggle in food
selection, along with various mental and physical disorders. There are four types of
malnutrition that are broadly classified like wasting, underweight, stunting and deficiency of
micronutrients. Chronic complications that may arise due to malnutrition are diabetes,
chronic heart disease, underweight and obesity. The condition is increasing worldwide, and
the rate drastically increases. There are many barriers in achieving a correct diet and most
important is person willingness. The paper also focuses on a case study who is suffering from
the underweighted condition and high cholesterol. The reason that underlies for this case is
improper management of food and lifestyle. The plan must include proper quantify of
balanced food. Lastly, the paper discussed the strategies that can be implied in reducing this
state in the client.