Nutrition in Nursing for Anthropometric Measurements-myassignmenthelp

Question: Discuss about theNutrition in Nursing Care for Anthropometric Measurements. Answer: The present paper will discuss optimal nutritional for nursing practice with a view to integrating nutritional interventions and policy into everyday nursing care. The nutritional care and interventions will be discussed in reference to a case study of a patient who is predisposed to diabetes type II and has interventional nutritional requirements. The anthropometric measurements used will be discussed with recommended weight loss targets, nutritional and physical activity recommendations and the nurse led role in behavior change and nutritional promotion. Anthropometric measurements Those used in the case study included height, weight, waist circumference and their derivatives Body mass index (BMI), waist to height ratio (WHR), and waist to weight ratio (WWR) (Australian Bureau of Statistics, 2013). These measurements are used to describe the body composition and try to stratify individuals according to the indices derived (Kondalsamy-Chennakesavan et al, 2008). Thomass measurements were a height of 175 cm, weight of 105 kg and waist circumference of 112 cm. The waist circumference is mainly a reflection of subcutaneous fat storage around the abdomen. The scale puts Thomas at substantially increased risk (102 cm or more). The waist circumference should be used in conjunction with the BMI for total obesity estimation and waist to height ratio for central obesity (Ashwell Gibson, 2016). WHR is derived by the division of waist circumference in centimeters by height in centimeters. Thomas has a WHR of 0.64. A blanket cut off of 0.5 is used to denote increased risk of obesity-related conditions (Ashwell Gibson, 2016). According to this, Thomas has an increased risk. The BMI is a measurement derived from weight and height and is a great tool used to stratify those who are obese and at a increased risk of cardiovascular disease and diabetes (Pasco et al, 2014). It is calculated by taking body weight in kilograms divided by height in meters squared (Nuttall, 2015). From this equation, Thomass BMI is 83.71. The BMI indices were categorized by the world health organization into categories of underweight, normal, overweight and obese. Underweight if less than 18.5, normal from 18.5-24.9, overweight from 25 to 29.9 and obese if 30 or greater (Lim et al, 2017). According to these strata, Thomas is clearly obese. Further WHO classification for obesity put her at class 3 obesity, the highest class for those with BMI of 40 or more. Weight loss is achievable and beneficial for Thomas who is class 3 obese. Weight loss goals will have to be set and individualized for him. Achievement of a desirable BMI may be an unrealistic goal in the short term but a slow and steady weight loss of 5% is still beneficial (Queensland Health, 2015). For goal setting and weight loss plan to be effective health education is an important prerequisite. The patient should be told the benefits of weight loss and lifestyle modifications. Thomas is at risk of type diabetes type two and cardiovascular events on account of his obesity and also from his family history where his father died of a heart attack and mother from a stroke. Nutrition and physical activity recommendations Nutritional recommendations are geared to modify the risk for development of diabetes and cardiovascular risks, reduce weight and complement other lifestyle modifications. According to Queensland health (2015), nutritional requirements should meet the energy requirements of the patient, include all the five major nutrient groups, be achievable and monitored. Thomas eats an unhealthy diet that consists of saturated fats like deep fried dim sims, chips, pork chops, Chico rolls, and meat pies, non-diet soft drinks, and foods with added sugars example soft drinks. His diet also lacks crucial components including fruits and vegetables. His daily alcohol habit is also detrimental to his health. The first recommendation is diet change to a more balanced nutritious diet and reducing energy intake (National Health and Medical Research Council, 2013). His breakfast which had white bread, honey, jam and coffee with milk should be changed to low-fat brown bread, use of sweeteners instead of sugar and honey and the addition of a fruit or a natural juice. His lunch should contain less deep-fried fast foods and include more cereals, vegetables, and water. If this is not available at his workplace, carrying packed lunch from home is a viable option. Dinner should include lean meats and poultry or fish with legumes instead of pork chops. Reduced fat milk should be used for tea and coffee. Drinking a lot of water with meals is recommended. Other eating recommendations include directives on portion size and serve sizes. Large portions and serves also lead to weight gain and overnutrition. According to Queensland health (2015), an adult of Thomass age need the following serves daily; six of vegetables, two of fruits, six of grains and cereals, three of lean meats, poultry and fish, two and a half of milk and dairy products, and four of polyunsaturated fats and spreads. Low-fat diets have been shown to reduce weight gain considerably (Makris Foster, 2011). Since he is class 3 obese, rapid weight loss is desirable and a very low energy diet is recommended (National Health and Medical Research Council, 2013). Use of adjunctive ways of weight loss is also recommended such as weight loss medication (Jin, 2015). Another recommendation is reducing or stopping alcohol consumption (Traversy Chaput, 2015). If willing to stop, referral to a center for alcohol addiction and rehabilitation should be attempted. If unwilling to stop, the alcohol content should be reduced to within two units per day (Traversy Chaput, 2015). Physical activity directly targets weight loss and prevention of weight gain by increasing energy consumption. Physical activity recommendations should encompass his occupation, leisure, and transport (National Health and Medical Research Council, 2013). Thomas level of activity is described as sedentary and carries a large risk of both obesity and cardiovascular risk (Barnes, 2012). The daily activities that fit him in this category include his occupation where he sits all day, driving to work daily and watching television after work. The Australian recommendations are to increase the level of intensity of physical activity to moderate to vigorous as they are the ones that carry health improving benefits (National Health and Medical Research Council, 2013). It prescribes that he should do about 150mins of vigorous activity or 300 minutes of moderate intensity activity or combining both models together with dietary modifications (National Health and Medical Research Council, 2013). Thomas could apply this by first walking to work which is achievable at two kilometers away. If not achievable bike riding to work is a ready alternative. He could take up leisure activities that are not sedentary and carry a better physical activity intensity, for example, swimming or join a gym or sports team. If these prove too expensive routine jogging is a cheaper option. Nurse-led role - promoting self-management Behavior change in weight management is crucial if any strategy is to work. The nurses role is to promote and spearhead the process of behavior change. The initial approach would be to apply several techniques that support behavior change. They include setting goals both long term and short term, encouraging self-monitoring, for example, a food diary or a workout plan, control of triggers of unhealthy behavior and cognitive behavior therapy (National Health and Medical Research Council, 2013). The main approach could be to individualized therapy or group therapy with individuals that share Thomass condition. Psychological therapies by the nurse could be applied and have been shown to enhance behavior change. They include cognitive behavior therapy and behavioral therapy (Teufel, Becker, Rieber, Stephan, Zipfel, 2011). This can be supplemented by other strategies to augment behavior change. They include incentives for weight loss and use of technology for example programs that set goals, reminders and offer information on the same (National Health and Medical Research Council, 2013). In conclusion, the anthropometric measurements used included weight, height, waist circumference (WC) and their derivatives BMI and waist to height ratio (WHR). Use of multiple measures reduces the shortfalls of just one to predict the risk of obesity-related conditions. The goals of weight loss do not have to involve rapid weight loss to achieve a normal BMI since that can be impossible. Even a 5% weight loss is beneficial. Nutritional recommendations aim at reducing energy intake and physical activity recommendations aim at increasing energy expenditure. The primary care nurse should foster behavior change to sustain these lifestyle modifications with psychotherapy and support in helping patients set goals and monitor their progress. References Ashwell, M., Gibson, S. (2016). Waist-to-height ratio as an indicator of early health risk: simpler and more predictive than using a matrix based on BMI and waist circumference. BMJ Open, 6(3). Australian Bureau of Statistics. (2013). 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