Soap Charting For A Patient (child)

Here is the food displayed for dchrisinger on 4/2/2008

Foods Consumed

Select Serving Size

APPLE (APPLES), FRESH BREAD, WHOLE WHEAT CHICKEN BREAST, BROILED, W/O SKIN COOKIE, OATMEAL W/ RAISINS OR DATES GRAPE SODA GRAPES, FRESH HONEY BUNCHES OF OATS CEREAL JELLY, ALL FLAVORS MASHED POTATO, FROM FRESH, MADE W/ MILK MILK, 2% MIXED VEGETABLES, FROZEN, FAT ADDED ORANGE JUICE PEANUT BUTTER POPCORN, AIR-POPPED, BUTTERED POTATO CHIPS, PLAIN & FLAVORED SUNNY DELIGHT BEVERAGE

The 2005 Dietary Guidelines (DG) Recommendations for dchrisinger on 4/2/2008

Number of Servings (Enter a number (e.g. 1.5))

You may be at risk of being overweight. Please seek weight guidance from your health care provider.

Dietary Guidelines Recommendations

Number of cup/ oz. Equ. Eaten

Number of cup/oz. Equ. Recommended

4.6 oz equivalent

5 oz equivalent

Vegetable

1.5 cup equivalent

1.5 cup equivalent

Fruit

2.3 cup equivalent

1.5 cup equivalent

Milk

2.1 cup equivalent

2 cup equivalent

3.5 oz equivalent

4 oz equivalent

Amount Eaten

Recommendation or Goal

Total Fat

26% of total calories

25% to 35%

Saturated Fat

9.3% of total calories

less than 10%

104 mg

less than 300 mg

2208 mg

less than 2300 mg

Emoticon

Grain

Meat and Beans

Dietary Guidelines Recommendations

Emoticon

Cholesterol Sodium Oils

*

*

*

Discretionary calories (solid fats, added sugars, and alcohol)

*

*

*

Nutrient Intakes For dchrisinger on 4/2/2008

Nutrient Food Energy/Total Calories (kcals) Protein (gm) Carbohydrate (gm) Total Fiber (gm) Total Fat (gm)

Your Intake

Recommendation or Acceptable Range

1858

1449

60

19

297

130

23

25

53.6

51.6 - 72.3

Saturated Fat (gm)

19.1

< 20.6

Monounsaturated Fat (gm)

20

**

Polyunsaturated Fat (gm)

11

**

Linoleic (omega 6) (gm)

11

10

Alpha Linolenic (omega 3) (gm)

0.4

0.9

Cholesterol (mg)

104

< 300

Vitamin A (mcg RAE)

986.9

400

Vitamin C (mg)

116.2

25

Vitamin E (mg α -TE)

6.6

7

Thiamin (mg)

1.9

0.6

Riboflavin (mg)

2.3

0.6

26.4

8

357.4

200

2.3

0.6

5

1.2

754.6

800

Phosphorus (mg)

1168.5

500

Magnesium (mg)

310.3

130

Iron (mg)

20.1

10

Zinc (mg)

7.2

5

Selenium (mcg)

63.9

30

Potassium (mg)

2813

3800

Sodium (mg)

2208

1200 - 1900

Niacin (mg) Folate (mcg, DFE) Vitamin B6 (mg) Vitamin B12 (mcg) Calcium (mg)

Subjective:

Olivia Smith is a third grader who lives in a nice neighborhood with her family (mother, father and her 10 year old brother). Olivia is a very smart girl who loves to read. Olivia’s mother does the cooking and is the one concerned with Olivia’s weight. She lets the children choose how much they eat, and she tries with little success to limit Olivia’s snack foods. After school, the kids have access to the pantry that’s usually stocked with snacks. Olivia watches a lot of television, takes the school bus, and chose art over phys ed. this year. Her only activity includes a ½ hour ballet class once a week. She likes riding her bike with her brother, but they haven’t gotten around to doing so in the past month.

Objective: -Olivia is 8 YOWF; weighs 72.5lb and is 51 in tall -History of anthropometrics: Weight Height Age (lb) (in.) 2 26.2 34.5 3 30.7 38 4 36.2 40.5 5 42 43 6 50.5 46.5 7 60.9 49 8 72.5 51 -24 hour recall: Breakfast- ½ cup orange juice, 1 cup Honey Bunches of Oats cereal, 1 cup 2% milk Lunch- 1 peanut butter and jelly sandwich (2 slices whole wheat bread, 1 ½ Tbsp peanut butter, 1 Tbsp grape jelly), 2 oatmeal raisin cookies, 1 apple (medium), 1 cup 2% milk Snack- 1 small bag of potato chips, grape soda (12 fl oz) Supper- 2 oz broiled chicken breasts (no skin), ½ cup homemade mashed potatoes make with milk, ½ cup mixed vegetable stir fry with 1 tsp canola oil, 1 cup Sunny Delight beverage, ½ cup seedless grapes Snack- 2 cups buttered popcorn, 1 cup water

Assessment: Olivia’s estimated energy requirement is 1448kcals per day when classifying her as sedentary. Her current intake is about 1858kcals per day. Although she is meeting all the requirements for the food guide pyramid, she

is consuming too many calories. Her percentage of fat from calories and her saturated fat level is in the healthy range, but her intake of protein and carbohydrates are too high. Almost all of her nutrient levels meet or exceed the recommendation. Potassium and Alpha linolenic acid are the only ones below 80% of the DRI.

Plan: Olivia has a fairly healthy diet, but is currently at an unhealthy weight. If she would increase her activity level to “active,” her estimated energy requirement would match the amount she’s currently eating. If she can’t increase her activity by that amount, she must decrease her caloric intake. This can be done solely by cutting out snack foods, reducing her dairy to a lower fat version, and possibly cutting back on juices like Sunny Delight. Mom can help by not keeping snack foods in the house, or by making them less accessible. Follow-up appointment should be made in two weeks.