Assignment on Nutrition

Introduction

THe purpos eof this nutritional assessment report is to record the daily dietary intake of for 3 consecutive days using the Weighed Food Record Method and compare it with the estimated energy requirement (EER) of an individual to calculate the Energy Balance and evaluate its effect on the health of an individual.

To achieve the aforesaid purpose a combination of techniques are used for the dietary assessment. This involves recording an exact derscription of the food consumed including their ingredients including the nutritional values of the food consumed for 3 consecutive days. Secondly the daily energy expenditure for 3 consecutive days have been recorded by maintainign a 24 hour timesheet for 3 days. This records the daily activity for each of the three days in 5 min intervals. Energy cost of each avtivity has been calculated using Guthrie (1989) estimated values to provide a basis for the estimated energy expenditure for each day.

Anthropometric data such as height, weight, body-mass index and age has been recorded to calculate correctly the Basal Metabolic Rate (BMR). Finally the results of the work performed are assessed against the acceptable standard measures and any significant deficiencies in nutritional status of an individual are identified and reasons therefor are appropriately recorded.

Findings and Analysis

The recordings from the dietary intake data and energy expenditure were recorded in tables and calculations were made as per the requirements. The following table presents the results from the dietary intake data analysis of the 3-day food record. The nutritional facts relating to each food consumed were measured using the online computer-based nutritional analysis package called FoodWorks. Accordingly the protein, carbohydrates and fat values are recorded including other nutritional facts and energy intake.

The daily figures have been obtained from the FoodWorks nutritional analysis tool. The daily dietary intake data recorded can be found in the Appendices section. The raw data for Day 1 is presented in Appendix 1, that for Day 2 is in Appendix 2 and for Day 3 in Appendix 3. Wherever possible, an exact measure of the food and beverages consumed along with the exact description of the ingredients consumed have been recorded in these tables presented in Appendices.

The average daily amountis compared with the standard measure Nutrient Reference Values (NRVs) provided in Table 4. This is shown below.

The findings from the above table contribute to the understanding of the sufficiency or deficiency of major nutrients that comprise the composition of the daily food data. Alcohol was not the part of daily diet in any of the three days.

The table 5 presents the contribution of each macronutrient, namely protein, carbohydrate and fat to the enerygy requirements of the body. These figures have been obtained directly from the Table 3 and here they are compared with the Acceptable Macronutrient Distribution Range (AMDR) which provides an estimate of the intake range for each macronutrient expressed as a percentage of contribution to the daily energy requirement. This also allows the sufficient intake of all other nutrients so that general health outcome can be maximized (NHMRC et al, 2006). The executive summary of the NRVs have been used to extract these figures.

Table 6 presents the average daily intake of polyunsaturated fat, monounsaturated fat and saturated fat included in the diet. These figures are then used to calculate the P:M:S ratio which is compared with the recommended values in the Results section.

The energy expended on daily activities for the 3 days have been recorded in Table 7. These figures have been arrived as follows:

Where,

EC = Energy Cost of the Activity

H = Hours spent on the activity

W = Weight of the individual

Activity calculations are shown below.

The 3 day activities recorded in the time sheet are presented in the appendices section. The abbreviations used for the easy presentation of activities are covered in Appendix 4.

The energy balance data summary is provided in Table 11. This is calculation on the basis of figures arrived at from the previous tables. The Basal Metabolic Rateg has been determined using the Schofield’s equation. The Physical Activity Level (PAL) figure used with the Schofield’s equation has been adapted from Black et al (1996), German Nutrition Society (2002), and FNB:IOM (2002). The table is presented below.

Discussion and Results

The food intake records maintained were tried to be kept as much accurate and consistent with the daily intake patterns as possible. Although it must be realized and accepted that the act of being in a 3 day observation and nutritional assessment program may somehow affect the individual’s eating pattern and craving for food, but it was tried to be kept to the representative of the usual daily eating patterns and consistent with the daily routine.

Likewise the physical activity record was fairly consistent with the usual work and home routine. Their were no additional influences to the daily physical activity and the activities performed were recorded with the help of a sibling who maintained all the intake and pjhysical activity records independently.

The food intake may not represent the actual nutritions due to the fact that the lunch meal was taken from the outside restaurant and exact ingredients could not be determined. However, the general nutritional values and facts have been kept in mind and observed from a variety of sources in addition to the FoodWorks nutritional analysis tool to present the most optimum intake of macronutrients possible. Accordingly the figures used are sufficiently realible for the assessment.

The three days were enough to be able to see the reasonably well and unbiased picture of the daily diet and activity routine. This is because the subject is a university student with consistent daily activity routine and the foods used do not differ significantly. However the diet may change on weekends which has not been incorporated in the anslysis.

A comparison of the findings and the relevant NRVs including EAR, RDI, AI, SDT and UL have been used to draw conclusions regarding the nutritional assessment of the individual. Based on the work performed and findings obtained the following conclusions have been made.

• The average daily intake of Protein is 110.85g which is greater than estimated average requirement for women i.e. 37g.
• Daily intake of Protein is also greater than the recommended value i.e. 46g. This can be fixed by consuming more salad and fruits and less meat and eggs.
• The food taken does not contribute sufficiently to the dietary fibre requirements of the body as only 11.66g are consumed on average as compared to the 25-30g adequate intake. A deficiency is likely to develop if dietary fibres are not increased in a the long term.
• The quantity of sodium consumed is significantly higher than the upper level intake which is 2300. In order to fix this excessive consumption of sodium should be reduced as soon as possible. Pizza contained in the daily diet as a dinner meal should not be used. Moreover pizza and mayonnaise should not be used more than once a week to reduce the sodium intake.
• Average total daily intake of water is 1.5 litres which is lower than the adequate intake of 2.8-3.4 litres. Although the deficient water requirements might be met through other sources such as tea and coffee and drinks, it is highly recommended to increase the water consumption by atleast 4 more glasses per day to avoid any health complications and maintain good health.

From findings in Table 5 it is evident that the macronutrient contribution to energy requirements of the individual are farly consistent with the acceptable macronutrient distribution range (AMDR). This means the daily diet of the individual is composed of a varity of macronutrients all taken in the correct contribution daily. However, the amount in grams are higher which has resulted in the higher level of energy intake than required. This has resulted in a surplus of energy in the body.

Table 6 has shown the calculation of the PMS ratio which has come out to be 1 : 1.6 : 1.8 in contrast to the ideal PMS ratio of 1 : 1 : 1. Generally the higher the PMS ratio the greater would be the cholesterol lowering effect in the blood which would prevent the cholesterol from building up in the body. This is highly necessary for the prevention of various heart and blood diseases such as blood pressure, diabetes, high cholesterol, hypertension, cardiovascular diseases, arthritis, some cancers, and gallbladder and kidney diseases.

Some of the symptoms that might be present in the individual due to the deteriorated PMS ratio may include high blood glucose, high waist circumference, low HDL cholesterol, and high blood pressure.

The results arrived at the final Table 11 show that the subject’s body has excessive energy balance i.e. energy intake is greater than the energy expenditure or there is a positive energy balance. This may lead to building of fatty tissues in the body and consequent the weight is liekly to increase in near future which is due to the energy imbalance in the body. The reasons for this is the excessive intake of energy in the form of various foods and the lack of physical activity.

In order to develop a energy balance, the energy intake needs to be cut down and the physical activity needs to be reduced. It has been observed from the daily physical activity tables that most of the activity comprises of sitting in class and attending lectures, reading, typing or reading. It is recommended to accompany these activities that require physical exersion as well apart from the mental energy in studying. This can be occasional exercise, early morning jogging in parks, running on a treadmill or just allotting a part of the day for the gym. Cycling can also be a good activity to spend time on.

The estimated energy requirement (EER) from the NRV table is 9945.2 kJ/day as compared with the EER calculated from the Schofield equation which is 8625.8kJ/day.

Conclusion

Based on the nutritional assessment conducted it has come to attention that there exists a high positive enerygy balance in the subject which needs to be dealt with in order to avoid being overweight. For this purpose the NRVs have assisted in making appropriate recommendations relating to the daily nutritional intake as a result of which valuebale insight with regard to the diet and physical activity of the subject has been obtained.