HPI: Jose Garcia is a 68 year old male with a PMH of HTN, high cholesterol, and arthritis in both knees. He is also pre-diabetic.
Social history: Currently smokes a half a pack a day. Mr. Garcia is largely sedentary, and is a retired taxi driver.
Other information: BP 148/88 on his BP meds, Fasting Glucose: 120, Weight: 250 lbs, Height: 5 feet 6 inches, Waist circumference: 45 inches
Goals: To lose weight and avoid becoming diabetic.
Breakfast
Current: Mr. Garcia currently eats a buttered roll when he goes to work. When he is at home, he eats eggs or pancakes.
Recommendation: Mr. Garcia should minimize processed carbohydrates by including some whole grain options into his breakfast. This could include substituting the buttered roll with whole grain toast. Whole grain alternatives are rich in nutrients and vitamins and are a great alternative for prediabetic people who need to monitor their blood sugar.
Lunch
Current: Mr. Garcia currently has a sandwich or will have a steak and fried plantains at a local Dominican restaurant.
Recommendation: Mr. Garcia should try making sandwiches that include whole grain bread or substitute the bread with lettuce. Additionally, adding lots of vegetables to the sandwich can make it more nutritious and contains several antioxidants and vitamins. At the Dominican restaurant, an alternative to the steak can be ordering chicken or lean meats. This can still provide a sufficient amount of protein. An alternative to the fried plantains can be baked or roasted plantains.
Dinner
Current: Mr. Garcia currently eats meat or fish with plantains or rice and beans.
Recommendation: Mr. Garcia should substitute his rice with brown rice. It is important to control the portion size when taking in rice. In addition to the beans, Mr. Garcia should include more vegetables in his diet. Vegetables are low in fat and calories and provide a great source of vitamins.
Dessert
Current: Mr. Garcia currently eats pastries and flan, and occasionally chicharrones.
Recommendation: Mr Garcia should avoid eating processed foods too often. Mr. Garcia should try eating dessert as a sweet treat once in a while instead of making it a part of his daily routine. Instead, Mr. Garcia can substitute the sweet treats with a wide range of fruits or low fat yogurt. This can provide Mr. Garcia sugar and fiber as healthier alternatives. Mr. Garcia should also try to avoid eating the deep fried chicharrones too often. He can substitute it with high protein snacks, such as nuts and seeds, which can provide proteins and minerals.
Exercise Plan:
Currently, Mr. Garcia states he does not exercise often. He states that he can walk up a flight of stairs without shortness of breath. But in office, when he does so, his respiratory rate is 30. Becoming more active can greatly reduce Mr. Garcia’s risk of becoming diabetic. Since Mr. Garcia is currently sedentary, some gradual changes that Mr. Garcia can incorporate into his daily life including beginning with a few minutes of physical activity per day and increasing slowly to 30 minutes per day. Mr. Garcia can do light physical activity, which includes doing things he enjoys such as handball and biking. Other light physical activities include swimming, gardening, or vacuuming. Since Mr. Garcia has arthritis in both knees, these light physical activities are ideal for him to become more active.
