A 22-year-old female student and CNA reports exercising 1.5 hours per day 5 days a week through running and HIIT to gain lean muscle and lose weight, but has seen no major weight changes in the past 6 months. Her diet analysis showed a low calorie intake of 1360 kcals per day that was high in carbohydrates but low in important vitamins and minerals. The assessment determined her very low calorie intake was due to consuming foods from only one or two food groups and eating small portions of low calorie foods. The intervention plan focuses on behavior modification to increase her calorie intake to recommended levels, dedicate more time to food preparation, and consume foods from all major food groups

1. ADIME Note
Assessment:
22-year-oldfemale worksasafull time student/CNA andreportsmainlytoanactive lifestyletogainlean
muscle andlose weightbyrunning&HIIT for 1.5 hours/day5 daysa week.Patientreportsnomajor
weightchange withinthe past6 months. Complains aboutbarriersof work/timetogetexercise inor
prepare food.
Diet Hx: (from24 hr recall) lowcaloric(1360 kcals),highcarbohydrate diet(189 g or 55% of kcals) of
natural whole foods.Calcium, potassium,magnesium, selenium, VitaminB12,D, E, K,and choline under
target. Dietconsistsof highcarbohydrate fruits/starchyvegetables,highsaltysnackfoods,andnomeat
or dairyproducts.MEDFICTS Assessmentfinalscore is6-verylow tobe consideredahearthealthydiet.
CW:59 kg UBW:59 kg % UBW:100%
Ht: 162 cm
BMI: 22 (normal)
IBW: 56 kg %IBW:105%
TSF (site 1): 20 mm Site 2: 25 mm Site 3: 14 mm
WaistCircumference:29 in Hip/WaistRatio: 0.75 (normal)
BF%: 23.2% MAC:20.75 cm AMA: 34.5 cm2
Frame Size:small BP: 106/73 (normal) FBG: 90 mg/dL (normal) UNN:-4.448 (low)
Medications:None Vitamins/Supplements:Multi-dailyvitamin
REE: 1335 kcals Estimated Kcal (w/ activity factor): 2069 Total Protein:47.2g
Diagnosis:
Verylow calorie consumptionrelatedtoconsumingfoodsfromone ortwo foodgroupsonlyandeating
smallerportionsof lowkcal foodsasevidencedbyaverage dailyintake of caloriesdroppingbelow
recommendedneedsof 2069 kcals.
Intervention:
NutritionrelatedBehaviorModificationTherapyusinggoal setting/self-contracttechniquestoguide the
clienttoincrease total calorie intake, dedicatingmore time topre-preparefoods,andconsume foodsin
everyfoodgroupincludingmeat anddairy.
Outcome Goals:
 Increase total dailycalorie intake to2069 kcals.
 One day a week,find2-3hoursto prep mealsforthe week.
 Increase energylevels
Action Goals:
 Clientagreestopackpre-preparedmealseachmorningforthe day
 Clientsagrees toeata servingof dairyfor breakfast
 Clientagreestopurchase foodsineachfoodgroup(dairy& meat)
 Clientagrees tohave a servingof meatontheirlunchand dinnerplate
Monitoring andEvaluation
Will followupwithclienteachmonthtoassesattempteddietarychanges/eatingpatternsandmonitor
weightmaintenance.