Nichelle is a college student who is training five days a week in the gym towards the goal of improving her strength and endurance and getting chosen for the rowing team at her school. She had been complaining about a 10-pound weight gain since starting college so a friend told her that she should also lose some weight before rowing try-outs because the sport has weight classes for boat assignments. Nichelle’s parents are overweight and have type 2 diabetes and she wants to keep those conditions from happening to her.
Nichelle normally does not follow any specific diet and describes herself as a picky eater. She has never liked leafy green vegetables because of the texture. Citrus fruit bothers her stomach. She avoids meat and fish because of the taste, but eats poultry once every week or two or when her parents visit once a semester. Nichelle has been avoiding gluten (mostly wheat) and cow’s milk for a year because she read on social media how it was a healthy thing to do. Now in preparation for try-outs, she is trying to keep her daily calorie intake below 1,400 calories to lose weight. Here is her current eating pattern:
Nichelle’s current weekday menu:
Breakfast: Plain flavor rice cakes with strawberry jelly added,
eaten as she walks to class, 8 oz. black coffee
Lunch: Peanut butter on slices of an apple, 12 oz. diet cola
Snack: 8 oz. Latte made with almond milk from coffee shop
Dinner: Makes a stir fry with tofu and a few frozen green beans to put over white rice or
uses leftover rice and mixes in frozen corn, canned black or kidney beans, and salsa,
12 oz. diet cola
Snack: A couple bite-sized Halloween chocolate candy bars, 8 oz. black tea
Fatigue complaint: Nichelle reports feeling very fatigued throughout the day and is finding it tough to endure a full work-out without feeling exhausted and that is why she started to include coffee, tea or soda with each meal and snack to boost her energy. A friend recommended two dietary supplements to help boost energy (see labels below) that Nichelle now takes. The friend said that the chromium will help her use her carbohydrate energy during her work-outs so she won’t get tired, plus it can help her prevent diabetes. She said the magnesium and zinc in the supplements offer an extra benefit because they will help her avoid muscle cramps and catching a cold. Since making the changes listed here to combat fatigue, Nichelle is sleeping poorly because she is awakened with heartburn (called gastroesophageal reflux or GERD) most nights, which adds to the fatigue.
Weekends: Nichelle has been skipping snacks and dinner to save up calories and go out both nights with friends, playing drinking games with tequila or vodka plus having several beers. She estimates that she has been having 5 shots each night but one night ended up in the infirmary when she combined vodka with an energy drink and drank more than usual, blacking out on a staircase and falling. To help with her goal of weight loss, Nichelle decides that she will only drink vodka and stop drinking beer in order to save calories. And, she will try to drink only once a week and not go over seven drinks so that she is within the recommended weekly guideline for alcohol in women. Nichelle also plans on gearing-up with extra clothing layers during her exercise to cause even more weight loss from a work-out.
Two Supplement Labels
Supplement #1 Maxi Health Supreme
Supplement #2 Mineral supplement
Three Questions: Be sure to answer all questions within each question in order to receive full credit. Each question is worth five points and so requires an appropriate depth of response.
Reminder- the exam is only on vitamins, minerals, fluid/caffeine/alcohol. Keep your responses to these specific content topics
Considering her intake without the dietary supplements, is Nichelle at risk of any micronutrient deficiencies? If so, list the specific individual micronutrient(s) and why you believe the specific deficiency risk exists for each micronutrient you list. If not, explain why is she not at risk of any micronutrient deficiencies. Be sure to specifically explain why you think she is/isn’t at risk. Back up your answer using resources from class and specifics from the case that support your answer. Be specific about any guidelines or criteria that you used in making your decision. Note: There is no need to enter Nichelle’s diet in Cronometer or similar apps to answer this question – no need for specific numbers here. Instead, use materials from both the vitamin and mineral Modules/class slides and critical thinking to support your answer. Think about factors that put someone at risk for a nutrient deficiency when you answer this question (5 points)
2. This question addresses Nichelle’s fatigue as well as her dietary supplement use. (5 points)
a) List two nutrition-related reasons why Nichelle might feel fatigued. Limit your answers to the topics from this exam only – vitamins, minerals, and fluid/alcohol/caffeine.
b) Share with Nichelle your thoughts about how she is combatting her fatigue. Are her efforts to combat fatigue effective or not? Explain why or why not.
c) Within your response, be sure to address the dietary supplements mentioned in the case (labels included) that Nichelle is taking to deal with her fatigue. Evaluate both of these supplement labels and share your assessment of whether or not taking both supplements is advisable. Do not base your response on only one supplement.
If taking both supplements is not advisable, explain your rationale for that opinion and list your specific concerns with her taking both supplements using facts and class materials that support your answer. Refrain from responding that she should take one of the supplements – this question is about her taking both supplements
If you would advise that Nichelle take both supplements, explain your rationale for that opinion using facts and class materials that support your answer.
Explain the effect Nichelle’s weekend eating and drinking habits have on each of her listed personal goals. List her goals and, using class materials, give Nichelle advice about how her nutrition lifestyle habits are affecting each goal. Offer her one idea for improvement. (5 points)