RAP

PROJECT
SPRING
2016
Jose Mendez #1714

DH 256

Dear RAP Patient

I would like to start by thanking you for participating in my project. After
analyzing the information you provided about your food diary it was entered it into
software that analyzes whether the nutritional requirements are been met or not, It divides
them into macronutrients which include protein, carbohydrates, fats and It will also
determine your micronutrients levels
The recommended daily intake allowance for calories was not met. Your daily average
calorie intake is about 1039 per day which is about 1,003 under the recommended daily
allowance. Your goals for macronutrients were met by 50% and you were also deficient
in some of your vitamins and minerals. For example, your fiber was below 62% of your
recommended daily minimum and your vitamin D was below 25%. Other vitamins and
minerals that were low included vitamin C, vitamins B, vitamins, E, and K. magnesium,
Potassium, and zinc were also low compared to other vitamins and minerals that also
fluctuated throughout the three days.
It is important you check with your doctor to see if he has any recommendations
about your diet. My recommendations to you are to contacting your nutritionist and ask if
he recommends a daily multivitamin to supplement the nutrients missing in your current
diet. As you know it is important to eat a certain amount of food throughout the day to
fuel your brain and body, your diet analysis showed you were also low in vitamin D
solely based on what you were eating. I would also like to recommend that you make
sure you are eating enough. If you are looking to lose weight, a dietician or your
physician may have helpful suggestions. I hope that the information provided in this letter
will help you make better choices on the kinds of foods you need to eat. If you have any

questions feel free to contact me and I will be happy to answer them or refer you to a
professional who can assist you.
Sincerely, Jose Mendez

I)

Nutritional Analysis
1) Carbohydrate intake: Patients Carbohydrate intake decreased but she
is still over the recommended RDA of carbohydrates.
2) Vitamin intake: Patients Vitamin intake increased.
a) 1st 3-day diet journal- 173 minutes of sugar exposure.
a) 2nd 3-day diet journal-120 minutes of sugar exposure.
3) Analyze BMI:
a) Patients weigt:135lb
b) Patients Height: 52
c) BMI: 24.7 She is (normal weight)
4) Activity Analysis:
a) Activities: house cleaning 3-4 times a week,2mile run 3times a
week
b) Activity Level: High
5) Nutritional Counseling:
a) Patient met 78% of targets
b) Patient is not deficient in micronutrients
c) Patient deficient in: vitamin C, D, K, potassium & iron, and water.
b) Advised patient to:
1) Increase H2O intake to 2,000g/day (8-9 cups)
2) Get vitamin C from leafy green veggies, broccoli, tomatoes,
and berries.
3) Get vitamin D fatty fish, eggs fortified cereals.
4) Get vitamin K from frozen kale/spinach.
5) Get iron from meat, beans, nuts, sunflower seeds.

A. This patient was born and raised in Watemala City so the kinds of foods that they
consume are very different that the foods that we consume in the U.S. which
involve many sweets and foods that contain high amounts of sugar and
carbohydrates. The patients socioeconomic status plays a major role in the
nutritional aspect as the choices she has to make regarding the kinds of food she
eats. She is a house wife and her husband is a full time student so they are berry
limited on how much they spend on food and eating healthy sometimes gets
expensive.
B. Once the nutritional analysis came around, the patient was already very
knowledgeable as to healthy and unhealthy foods. What she did not know was
what foods affect oral cavity.
C. Once the first three-day diet journal was given to the patient, it was explained to
her that the 3-day diet analysis that she was given wasnt just more work but
rather a really important tool to understand her nutritional health and as a result
she became more involved during the second appointment.
D. Patients Carbohydrate intake decreased but she is still over the recommended
RDA of carbohydrates. Patients Vitamin intake increased. Patient is not deficient
in micronutrients however Patient is deficient in vitamin D, K, potassium, iron,
and water.
E. Upon reviewing the patients diet analysis, many of the foods that she was
consuming fell into the category of healthy foods. Some food items such as
vegetables and mixed greens, yogurt, fruits, fish, and white rice.

F. She started to understand what kinds of carbohydrates she would be avoiding, and
how often she should be eating. The difficult part for her was to write what she
ate, and to limit the snacking and to achieve her nutritional needs. 1st 3-day diet
journal patient had 173 minutes of sugar exposure which depicts the average daily
acid production below 5.5pH. 2nd 3-day diet journal-120 minutes of sugar
exposure. This is important to discuss with the patient in regards to the pH and the
balance that must be maintained within the mouth. While explaining the process
of tooth decay is higher when the PH is below 5.5. The patient was explained that
by eating sugary foods and the bacteria feeding off the remaining food particles,
the bacterias waste produces acid on the teeth which demineralizes the tooth
enamel. The results were noted on 2nd 3-day diet journal the sugar exposure time
which dropped to 120 minutes of exposure time.
G. patient was advised to Increase H2O intake to 2,000g/day (8-9 cups)
Get vitamin C from leafy green veggies, broccoli, tomatoes, and berries.
Get vitamin D fatty fish, eggs fortified cereals.
Get vitamin K from frozen kale/spinach.
Get iron from meat, beans, nuts, sunflower seeds.
H. The patient was very interested and compliant in the nutritional counseling,
because this was what she was interested in. During the second round of diet
journals and carbohydrate analysis, it was obvious that the patient understood
what was taught, and that she was making an effort to drop the sugar exposure
time as well as achieving her nutritional goals. On her 2nd 3-day diet journal the
sugar exposure dropped to 120 minutes of exposure time. Her carbohydrate intake
dropped, her water intake increased, her lipid intake decreased, her vitamin intake
increased as well as her minerals and proteins.
I. There was excitement at the third appointment when the patient came back due to
the fact that the patients diet had improved. She was very compliant and exited,

her water intake had increased, and she was in taking more of the minerals and
nutrients that she was lacking. She mentioned that she felt better and that she was
going to continue trying to accomplish her nutritional goals, it was not going to be
easy because it takes a lot of work and effort but it was something that had to be
done and because it would benefit her.

Works Cited

Stegeman, C. A., & Davis, J. F. (2015). Dental Hygienist's Guide to Nutritional Care (4th
ed.). St. Louis, MO: Elsevier - Health Sciences Division.