Non-Alcoholic Fatty Liver Disease

Case:
Natasha is a 45 y/o nurse who works for a local hospital. She goes to her doctor for her annual physical. She reports that she has been feeling more tired and has gained about 15-20 pounds in the last year. She has been under much stress at work, raising her teenagers and assisting her elderly parents. At her visit, her doctor voices much concern over her lab work and weight gain. A 24-hour recall of her diet is also recorded (see food report Download see food report). She is diagnosed with NAFLD, Non-Alcoholic Fatty Liver Disease, and is set up with a follow-up with her physician after she sees a Registered Dietitian.
Anthropometric Data:
Height: 5ft 3 inches Weight: 185 pounds Waist Circumference: 38inches
Blood Pressure: 140/90
Lab Work
Test Patient's Values Normal Range
Blood Glucose 102mg/dl 80 - 100 mg /dl
Hemoglobin A1C 6.0% < 5.7%
Cholesterol 296mg/dl < 200 mg / dl
Triglycerides 300mg/dl <150 mg / dl
Liver enzymes:
alanine aminotransferase (ALT)
45U/L
7 - 56 U / L
aspartate aminotransferase (AST)
57U/L
5 - 40 U / L
Step 2 Answer the Questions in a post.
Remember, this is an assessment of what you learned in modules 1-2, plus some reading about NAFLD treatment. The post should thoroughly answer each of the following questions:
Open the Food Report. Looking at the Macronutrient Distribution within the report, which macronutrients (and their sub-categories) are not in range? Note you will scroll down to page 11 in the reports to locate the macronutrient distribution.
Looking at the Spreadsheet in the food report, which foods contribute to macronutrient imbalances? i.e. what individual foods in her diet caused her macronutrients (and sub categories) in Q1 to be out of range?
Referencing the sources in this discussion and the text, what changes in her food intake would you suggest? i.e. what foods would best replace the less healthy options you identified in Q2. To encourage patients to make healthy changes, we want to use inclusive language and suggestions that honor their preferences. Thus, you should make comparable food substitutions for each food you identified as a problem in Q2. (i.e. Instead of cheese sauce with your tortilla chips, you might substitute salsa or guacamole).
Natasha’s favorite food is the Beyond Burger. Looking at the Nutrition Facts label, evaluate the macronutrients, and explain if it would be a good choice for her or not. If it is a poor choice, what would be a good plant-based alternative? In your answer, consider what is good for Natasha. i.e. knowing she has NAFLD, what nutrients are a concern for the condition? Does this food provide nutrients that exceed what she should consume for those nutrients of concern?
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Purpose:
This assignment aims to evaluate a diet's nutritional composition and the lab values of a patient with NAFLD, Non-Alcoholic Fatty Liver Disease. This will help you to make the connections between dietary intake, lab values, and liver disease to suggest practical recommendations for your future patients with this condition. The information gathered here will also provide a foundation for the final project (Patient education Handout) that you will create at the end of the term.
Consider this a supplement to your exam. This assignment intends to assess how well you can apply the content you learned in modules 1-2 to a real-life case study. It is an additional measure of learning beyond the multiple-choice test.
Learning Outcome:
Students will:
Identify risk factors for NAFLD
Identify the dietary and lifestyle components to treat & prevent NAFLD.
Identify the differences between NAFLD and alcoholic-related liver disease.
Identify appropriate management of NAFLD