Question

Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

1. Prior to gaining 15 pounds over the last six months, Ellen was _____ which is associated with _______, an underlying cause of most other chronic diseases.
a. overweight; heart disease b. overweight; metabolic syndrome c. obese; chronic inflammation d. obese; heart disease e. obesity; cancer 2. Which is a risk factor for chronic diseases based on Ellen's current diet and lifestyle?
a. High consumption of plant proteins b. Low added sugar intake c. A diet high in vitamins and/or minerals d. Low intake of fiber and phytochemicals e. Excessive alcohol intake 3. All of the following are modifiable risk factors for cardiovascular diseases EXCEPT:
a. High triglycerides. b. Hypertension. c. Physical inactivity. d. Osteoporosis. e. Atherogenic diet. 4. Ellen's doctor also orders a lipid profile and reviews the results in conjunction with the results of her history and physical examination. Which of the following does NOT constitute a high risk for heart disease?
a. Total blood cholesterol of 240 mg/dL. b. LDL cholesterol of 190 mg/dL c. HDL cholesterol of 37 mg/dL d. Triglycerides of 200 mg/dL e. Fasting plasma glucose 95 g/dL 5. To decrease her risk of cardiovascular disease, Ellen should do all of the following EXCEPT:
a. Limit saturated fat to less than 7 percent of daily kcalories. b. Limit trans fats to less than 1 percent of daily kcalories. c. Limit cholesterol to less than 200 milligrams per day. d. Limit sodium intake to less than 2500 milligrams per day. e. If consumed, have no more than two alcoholic beverages per day if male, and one if female. 6. A few weeks after Ellen started medication to lower her blood pressure, she remembers feeling weakness, numbness, cramps, irregular heartbeats, and excessive thirst and urination. These are likely signs of:
a. Diabetes Mellitus b. Anemia c. Magnesium deficiency d. Potassium imbalance e. Sodium imbalance 7. Ellen's doctor encourages her to reduce her risk of developing type 2 diabetes by making some lifestyle changes. All of the following diet and lifestyle changes are associated with reducing the risk of diabetes EXCEPT:
a. Lose weight. b. Increase physical activity. c. Replace frozen desserts with fruit options. d. Stop smoking. e. Drink water in place of soda. 8. The physician discusses with Ellen that there might be a higher risk for certain cancers as a result of her weight. These include all of the following EXCEPT
a. Colon cancer b. Breast cancer c. Endometrial cancer d. Lung cancer e. Esophageal cancer

Answer 1

Ellen was obese and at risk for chronic inflammation, which is a major contributor to chronic diseases. She should address her high consumption of sugars and lack of fiber, manage her risk factors for cardiovascular disease, and make lifestyle changes, including dietary modification, to reduce her risk of diabetes and certain cancers.

Step-by-step explanation:

Answering the questions regarding Ellen, a 55-year-old woman with multiple medical issues, particularly in regard to her obesity and risk for chronic diseases:

1. Prior to gaining 15 pounds over the last six months, Ellen was obese; which is associated with chronic inflammation, an underlying cause of most other chronic diseases.
2. Which is a risk factor for chronic diseases based on Ellen's current diet and lifestyle? The answer is Low intake of fiber and phytochemicals.
3. All of the following are modifiable risk factors for cardiovascular diseases EXCEPT: Osteoporosis.
4. Ellen's doctor also orders a lipid profile and reviews the results in conjunction with the results of her history and physical examination. Which of the following does NOT constitute a high risk for heart disease? The answer is Fasting plasma glucose 95 g/dL.
5. To decrease her risk of cardiovascular disease, Ellen should do all of the following EXCEPT: If consumed, have no more than two alcoholic beverages per day if male, and one if female.
6. A few weeks after Ellen started medication to lower her blood pressure, she remembers feeling weakness, numbness, cramps, irregular heartbeats, and excessive thirst and urination. These are likely signs of: Potassium imbalance.
7. Ellen's doctor encourages her to reduce her risk of developing type 2 diabetes by making some lifestyle changes. All of the following diet and lifestyle changes are associated with reducing the risk of diabetes EXCEPT: Stop smoking.
8. The physician discusses with Ellen that there might be a higher risk for certain cancers as a result of her weight. These include all of the following EXCEPT Lung cancer.

Answer 2

The case study focuses on Ellen's obesity, which is associated with chronic inflammation and increases her risk of developing chronic diseases. Modifiable risk factors for cardiovascular disease do not include osteoporosis. Lifestyle changes to reduce the risk of diabetes do not necessitate stopping smoking if she is not a smoker.

Step-by-step explanation:

1. Prior to gaining 15 pounds over the last six months, Ellen was obese; which is associated with chronic inflammation, an underlying cause of most other chronic diseases.

2. A risk factor for chronic diseases based on Ellen's current diet and lifestyle is low intake of fiber and phytochemicals.

3. All of the following are modifiable risk factors for cardiovascular diseases EXCEPT: osteoporosis.

4. Which of the following does NOT constitute a high risk for heart disease is fasting plasma glucose 95 mg/dL.

5. To decrease her risk of cardiovascular disease, Ellen should do all of the following EXCEPT: Limit sodium intake to less than 2500 milligrams per day. The recommendation for sodium intake to reduce cardiovascular disease risk is to consume less than 2300 milligrams per day, not 2500.

6. A few weeks after Ellen started medication to lower her blood pressure, the signs she is experiencing are likely signs of a potassium imbalance.

7. Ellen's doctor encourages her to reduce her risk of developing type 2 diabetes by making some lifestyle changes. The one that is NOT associated with reducing the risk of diabetes is stop smoking, as Ellen is not reported to be a smoker.

8. The physician discusses with Ellen that there might be a higher risk for certain cancers as a result of her weight. These include all of the following EXCEPT lung cancer.