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Anthropometric 

In the anthropometric section, the current weight of a 20 years old female student nurse is 50 kg. Two months ago the age of a female was 55 kg. H height of the patient is 158 cm. 

Biochemistry 

In this section, it is discussed about the rate of haemoglobin, the rate of sodium, CRP, and the measurement of blood pressure. The rate of haemoglobin is 10.4 g/dl, the rate of sodium is139 mmol/L, measuring CRP is 13.6 m/L, and measuring blood pressure is 120/80 mmHg. 

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Clinical 

In the clinical history, the patient has been suffering from weight loss, diarrhoea, abdominal pain, and anaemia. The patient was consulted by gastroenterologists. After the diagnosis the was confirmed coeliac disease and the was referred to dietary advice. 

Dietary 

Patients take breakfast at 8 pm. That is 1 glass of semi-skimmed milk, one slice of toast, and one glass of fruit juice. In the mid-morning, the patient takes fruit scones and butter and latte takeaway. Patients used to take lunch at 1 pm by purchasing at work which is vegetable soup, bacon or egg or lettuce or tomato sandwich with white bread and mayonnaise with diet coke. In the mid-afternoon, she only takes pk crisps. At 6 pm, patients have dinner with lasagne, coleslaw, potato, wedges, and slice fruit cake and in the supper, the patent takes a hot chocolate drink with two crackers and cheese. 

Environmental or social 

Patients live away from home by sharing a flat with four friends and taking alcohol four drinks on one night per week. 

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  1. 750

Dietary restriction has emerged with linking own diet and based on food selection patterns which help in maintaining health and prevent acute disease. It is required to learn basic nutritional principles and applications to the care of patients. Reduction of dietary carbohydrates is the first and foremost theory for reducing various diseases most commonly for carbohydrates. On the other hand, there is good scientific evidence to destroy patterns that are associated with everyday foods and average beverages which are specific for health and outcomes of disease. The diet contains adequate macronutrients but still, it will be deficient in vitamin A or other elements such as iron and this deficiency of nutrients may lead to xerophthalmia or anaemia, or low haemoglobin. On the other hand, high standard fat and diet may lead to coronary heart disease. Thus many nutritional constructs food-based dietary guidelines or FBDG. the reason for framing FBDG are many which as follows, food must be made up of diets and they must be often surprisingly with self-evident, in the presented food the nutrients interlinked at a different level, and methods of processing foods, preparation, and influence of cooking by maintaining the nutritional value of foods. However, scientific evidence has not found any evidence that has potential results in some non-nutrient foods and food components. Food and diets are associated with cultural, ethnic, social, and aspects of the family with the nutrients. 

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As per the history of the patient, she is a twenty years old female student with a history of weight loss, diarrhoea, abdominal pain, and anaemia. The haemoglobin measurement confirmed that the rate of haemoglobin is quite low, which is 10.4 g/dL. After the clinical investigation, it has been formed that the patin has been suffering from coeliac disease. Thus the patient was referred to dietary advice. As per previous diet history, the patient weight current weight is 50kg and previous weight is 55 kg that was 2 months ago and the height of the patent is 158 cm. The biochemistry results showed that the level of haemoglobin is 10.4 g/dL, sodium level is 139 mmol/L, CRP level is 13.6 mg/L, and blood pressure measured 120/80. The clinical history patient has been suffering from weight loss, diarrhoea, abdominal pain, and anaemia. In the previous diet, the patient had breakfast at 8 pm. That was one glass of semi-skimmed milk, one slice of toast, and one glass of fruit juice. In the mid-morning she used to take fruit scone with butter and latte, in the lunch at 1 pm, she used to make vegetable soup with bacon, sandwich, white bread and mayonnaise with diet coke, in the mid-afternoon she had pk crisps, at the dinner she had lasagne, coleslaw, potato, and wedges, slice fruit cake and in the supper, she had hot chocolate and two crackers and cheese. This lady needs to avoid gluten in her diet as gluten is a protein that is found in her herd diet and it is present in wheat, barley, and rye. On the other hand, it is found in cheese, bacon. Moreover, gluten lacks essential nutrients. Eating gluten-rich foods can undergo celiac disease that has triggered immune disease it develops inside the body and damages the gastrointestinal tract and also it damages the other parts of the body. As the lady has been suffering from coeliac disease she must avoid gluten-rich food as it has no nutritional value. The current estimation suggests that people who take excessively rich food may grow 1 per cent of the population has this condition. A gluten-free diet is required to remove from the inflammation as well as slow symptoms. 

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She faced numerous complications as she has been stuffing from abdominal pain, thus gluten is required to remove from the diet in order to eliminate the inflammation as well as diseased condition. Many foods offer gluten-free options that are rival to conventional foods in terms of taste and quality. In recent years it is hard to maintain a gluten-free diet. 

From the clinical investigation, it has been found that the patient is gluten sensitive, thus she has been suffering from abdominal pain due to infection occurring at the gastrointestinal tract. The early symptom that arises is diarrhoea. This is also known as non-celiac gluten hypersensitivity when poorly defined conditions appear. Avoid gluten that makes sense about celiac disease and feel unwell who will consume more gluten-rich food. 

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  1. 750 

  1. i) appropriate dietary plan for this patient that achieve the actual nutritional

goals

Meal 

One day 

Breakfast 

Pancake with banana and other fruits 

Lunch 

Poached egg with tomato on GF toast 

Dinner 

Dinner with roast chicken 

Snacks 

  • Clementine 
  • Nuts at the number of raisins 
  • Fromage fruits
  • 50g of dried apricot 
  • Banana 

Drinks 

  • 6 to 8 glasses of fluid that is mostly water
  • The glass of milk or milky hot drinks or hot chocolates 

Total daily nutrition 

Calories: 1980 

Protein (g): 85

Carbs (g): 220

Fat (g): 70

Fibre (g): 35 

  1. ii) 200 

A gluten-free diet mainly allows avoiding wheat that contains excessive gluten. And added some grain as a substitute that provides nutrients as a more hath diet. The glue-free diet is the part of the daily diet routine that excludes food that contains excessive gluten. Gluten is a type of protein that has no nutritional components and it is mainly found in barley, rye, and triticale. The purpose of a gluten-free diet is important for test the signs and symptoms of diseases like celiac disease and violate other mental conditions which are combined with gluten. As she is feeling abdominal pain the clinical investigation suggests a proper d plan that excludes gluten. On the other hand, a gluten-free diet is also popular among people who have not been clinically diagnosed with a gluten-related medical condition. The benefits of obeying such a gluten-free diet help in improving health, reducing weight loss and increasing body energy. Coeliac disease is a condition that is triggered by gluten if taking excessive amounts of gluten-rich food triggers the immune system and hampers their activity that damages the inner lining wall of the gastrointestinal tract. 

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iii) 300 

People who have been suffering from celiac disease may likely develop a nervous breakdown that creates nervous problems which are also known as neuropathy and also occur problems that hamper the control over the movement which is also known as ataxia. Moreover, inadequate vitamin levels may decrease the immunity power and lack of minerals also cause this. This also leads to immunogenic disease that damages the gastrointestinal tract. The small intestine uninterruptedly communicates with other parts of the body. People who deliver celiac disease may also cause appears disease in the liver, gall bladder and create conditions in the pancreas. The untreated or undiagnosed disease may create anxiety and appear depression and moreover celiac disease that leads to these problems. On the other hand, the patient faced more challenges as her haemoglobin rate is very poor.

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Moreover, within two months his weight was gradually decreasing by 5 kg. Side by side, the patient has been suffering from weight loss, diarrhoea, abdominal pain as it occurs due to the presence of infection in the gastrointestinal tract, and anaemia. After the clinical investigation, the patient has been confirmed that she has been suffering from celiac disease which referred to dietary advice. Moreover, the patient has low haemoglobin side by side if the data shows a low rate of haemoglobin, low rate of CRP and the blood pressure rate is normal. So the dietitian administered a simple diet plan that reduces the risk of celiac disease. 

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