INTRODUCTION
Mr. John is a 40-year-old man who has gained approximately 22 kilograms over the past 10 years, reaching a total weight of 90 kg. He has been diagnosed with diabetes and hypertension, alongside obesity. John consumes a high-calorie diet and has developed a habit of eating regularly at his workplace, where he has a sedentary job lasting 8 to 10 hours a day. His overweight condition is affecting his daily life, causing reduced mobility. Living alone, John prefers fast food and avoids physical exercise, further contributing to his obesity. His physician has prescribed him a controlled diet and regular physical activity to reduce excess body fat, as the additional weight exacerbates his hypertension and diabetes.John also has a history of hypertension and dyslipidemia, which have been complicated by his increased body weight. With a BMI around 30, his condition is classified as obese. He belongs to the BAME (Black, Asian, and Minority Ethnic) community in the country. Obesity is a significant health concern as it is linked to other diseases like high blood pressure, diabetes, and stroke. Individuals with excess body weight face the risk of further health issues, including a slow metabolic rate and other adverse effects on the body (Aburasayn, Al Batran, and Ussher, 2016). The goal of weight loss in John's case is to manage his blood sugar levels and blood pressure. It is necessary for him to improve his sedentary lifestyle and overeating habits in order to maintain a healthy body mass index (BMI). John sought advice from his general practitioner due to increasing complications with his health, in addition to taking his prescribed medications. The physician emphasized that weight loss is essential for controlling his diabetes, hypertension, and dyslipidemia.
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METHODS
Food diary, Food Tables and/or Dietary Software for dietary analysis
A food diary has been refereed to as a diet chart which contains information about intake of food items with proper quantity and calories with time. It is helpful to an individual to remain conscious and aware that how much calories they intake through daily meals which helps to reduce weight per week. By maintaining such diary, the doctor also get the type of eating habits the client indulge in their daily activities (Curtis and et. al., 2016). In case of given patient, he has a habit of continuous eating in short period of time with lack of physical activities that needs to be improved for reducing additional body fat to maintain diabetes and entire health condition of an individual. Reducing in weight of body is favourable to control diabetes easily with the help of regular medications and decrease relevant complications that occurs due to obese condition of John. The diet chart have been made below in context to manage the weight of Mr. John so as to overcome such person from obese condition.
Diet plan
Week days |
Breakfast |
A.M. Snack |
Lunch |
P.M. Snack |
Dinner |
Total intake |
Monday |
1 baked banana, nut oatmeal cups & 1 medium apple. (271 calories) |
1 clementine (35 calories) |
1 veggie & hummus sandwich (325 calories) |
1 medium banana (105 calories) |
1 sheet-pan chicken fajitas bowls with half cup cooked brown rice (468 calories) |
66 g protien, 177g carbohydrate, 34g fibre, 32g fat, 1186 mg sodium and 1203 calories. |
Tuesday |
1 medium apple & 1 baked banana-nut oatmeal cups (271 calories) |
1 hard-boiled egg or 1oz. Cheddar cheese (192 calories) |
1 Chipotle-Lime cauliflower bowls (344 calories) |
1 clementine (35 calories) |
1 Zucchini-Chickpea Burgers with Tahini-Ranch Sauce |
150 g carbohydrate, 30g fibre, 50g fat, 45g protein, 1488 mg sodium and 1215 calories. |
Wednesday |
1 Nut oatmeal cup & apple (271 calories) |
2 clementines (70 calories) |
1 Chipotle-Lime Cauliflower Taco Bowls (344 calories) |
1 medium sized banana (105 calories) |
1 easy salmon cake over 2 cups baby spinach (401 calories) |
35 g fibre, 36g fat, 95g protein, 176 carbohydrate, 1534 mg sodium and 1190 calories. |
Thursday |
1 Muesli with Raspberries (287 calories) |
1 clementine (35 calories) |
1 Chipotle-Lime Cauliflower Taco Bowls (344 calories) |
Half cup raspberries (32 calories) |
1 Chicken & cucumber lettuce wraps with peanut sauce (521 calories) |
62g protein, 159g carbohydrate, 42g fibre, 46g fat, 1109 mg sodium and 1220 calories. |
Friday |
1 muesli with raspberries (287 calories) |
1 hard boiled egg & half oz. Cheddar cheese (135 calories) |
1 Chipotle-Lime cauliflower taco bowls (344 calories) |
No meal |
Mediterranean Ravioli with Artichokes & Olives (454 calories) |
1478 mg sodium, 39g fibre, 49g fat, 51g protein, 161g carbohydrate and 1220 calories. |
Saturday |
1 serving Muesli with raspberries (287 calories) |
1 medium sized green apple (95 calories) |
1 veggie & hummus sandwich (325 calories) |
1 hard boiled egg (77 calories) |
1 Curried sweet potato & peanut soup and 1 (1-in.) slice whole wheat baguette (405 calories) |
168g carbohydrate, 38g fibre, 46g fat, 47g protein, 1281 mg sodium and 1190 calories. |
Sunday |
"Egg in a Hole" Peppers with Avocado Salsa (285 calories) |
No meal |
Curried Sweet Potato & Peanut Soup (345 calories) |
1 oz. Dark chocolate & 1 cup raspberries (220 calories) |
1 Spinach & Artichoke Dip pasta (371 calories) |
47g protein, 138g carbohydrate, 32g fibre, 58g fat, 1741 mg sodium and 1221 calories. |
Physical Activity Journal
Physical activity is must for John to increase activeness in his body and burn calories which gained by intake variety of food item per day. It is essential for every individual to conduct physical exercise daily for remaining fit and healthy. In context of given case, it has been analysed that overeating habits of patient results into extra intake of calories which cannot burn due to they convert into fat molecules and get deposited in body tissues. However, John has lack of physical activities in his daily routine with problem of overeating which is responsible for extra fat gained by an individual (Hunt and et. al., 2016). It has been analysed that diet is not sufficient in given case but continuous physical workout is also necessary for removing additional body fat.
According to the prescription given by general practitioner of John, it has been evaluated that effective physical activities should be follow by him in terms of maintain body weight which helps to control diabetes as well as hypertension. Basically, the patient is required to focus on daily morning and evening walk that increase metabolism and prevent deposition of extra fat molecules in tissues of human body. Meanwhile, it is required for selected individual to join yoga, aerobics, zumba classes and many more (Torjesen, 2016). Moreover, daily physical work out helps to improve mobility then they can prefer water aerobics also which helps to eliminate additional body weight. The physical activities were used in case of John because diet plan is not much enough to reduce weight but physical exercise was also essential as it is helpful to burn calories easily. It is suitable to balance the calories intake and calorie burn which facilitate to maintain body weight and other problems for remaining disease free. Meanwhile, the physical activity has been used because it is favourable for enhancing total energy expenditure that facilitate an individual to stay with energy balance along with reducing weight (Molino and et. al., 2016). It is also beneficial to decrease body and eliminate risk of developing abdominal obesity.
Predictive equations for energy expenditure
Predictive Equations for Resting Metabolic Rate (RMR) in kcal/day. All equations use weight in kilograms (kg), height in centimetres (cm) except the WHO/FAO/UNU equation that uses height in meters (m).
Mifflin-St Jeor
Men: RMR = 9.99 X weight + 6.25 X height – 4.92 X age + 5
Women: RMR = 9.99 X weight + 6.25 X height – 4.92 X age – 161
Harris Benedict
Men: RMR = 66.47 + 13.75 X weight + 5.0 X height – 6.75 X age
Women: RMR = 655.09 + 9.56 X weight + 1.84 X height – 4.67 X age
Owen
Men: RMR = 879 + 10.2 X weight
Women: RMR = 795 + 7.18 X weight
WHO or FAO or UNU
Weight only:
Age (yr)
Men
18-30 RMR = 15.3 X weight + 679
31-60 RMR = 11.6 X weight + 879
>60 RMR = 13.5 X weight + 487
Women
18-30 RMR = 14.7 X weight + 496
31-60 RMR = 8.7 X weight + 829
>60 RMR = 10.5 X weight + 596
Weight and height (m):
Age (yr)
Men
18-30 RMR = 15.4 X weight – 27 X height + 717
31-60 RMR = 11.3 X weight + 16 X height + 901
>60 RMR = 8.8 X weight + 1128 X height – 1071
Women
18-30 RMR = 13.3 X weight + 334 X height + 35
31-60 RMR = 8.7 X weight – 25 X height + 865
>60 RMR = 9.2 X weight + 637 X height – 302
Anthropometric measurement