Determine Rachel's initial nutrition prescription using her usual intake at home as a guideline, as well as your assessment of her energy requirements
What will be an ideal response?
Carbohydrate needs based on 45-65% of total kcal from CHO:
2400 x 0.45 = 1080 kcal/4 kcal/g = 270 grams CHO/d/15 grams/serving = 18 servings/day
2400 x 0.65 = 1560 kcal/4 kcal/g = 390 grams CHO/d/15 grams/serving = 26 servings/day
Current meals/snacks consumed: Breakfast, lunch, dinner, and a snack before soccer practice
Nutrition prescription:
90 grams CHO for breakfast, lunch, and dinner (6 CHO equivalents/meal)
30 grams CHO (2 CHO equivalents) for snacks, twice per day (one mid-morning and one before soccer practice or other physical activity)
It is typical in pediatric practice to not prescribe a certain amount of CHO. It is more important for the patient to understand the insulin: CHO ratio and cover her intake accordingly.
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