Determine Mitch’s initial CHO prescription using his diet history as well as your assessment of his energy requirements.
What will be an ideal response?
• According to his BMI, pt. should aim for weight reduction. According to calculated energy needs, pt. should follow 1900-kcal diet.
- To start, approximately 50% of energy should come from carbohydrates
- 1900 kcal x 0.50 = 950 kcal from carbs / 4 kcal/g = 237.5 g or 238 g carbohydrates
- Using ICR of 15 g carbs to 1 unit of insulin, 238 g carbs / 15g = 16 carb choices for the day
• Using his diet history as a reference, Mitch should aim to eat consistent amounts of carbohydrates throughout the day.
- 4-5 carbs for breakfast: 1 bagel, or small bagel with cream cheese (light), coffee w/ half-and-half (free)
- 1-2 carbs for a snack: piece of fruit, small- to medium-sized banana or apple
- 5-6 carbs for lunch: 12" subway sandwich, turkey with veggies, light on sauce if any (no chips)
- 5-6 carbs for dinner: 1 cup of rice, salad, grilled chicken, and 8 oz of fruit juice
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