Diabetes is raising health concern in India today. Heart health, impaired blood sugar levels are concerns for common man. Heart health and diabetes are categorised as lifestyle conditions. This case study represents dietary and nutritional management for both the conditions.

1. Case study:
Diabetic + Heart Patient
BY: MADHURA GURAV

2. Patient Profile
 Name Mrs. XYZ
 Age 61 years
 Sex Female
 Ethnic background Hindu :
Gujarati
 Occupation Housewife
 Activity Sedentary
 Socio economic status Upper middle
class
 Family history Obesity

3. Anthropometric measurements
 Height – 5’2” i.e. 157.4 cm
 Weight – 90 kg
 IBW – 52.4 kg
( Brocca’s Index)
 % IBW – 69.8% overweight
 BMI – 35.2kg/m2 (Grade II
Obese)

4. Biochemical Parameters
 Group I
Ob Values Normal
(mg/dL) (mg/dL)
 Blood sugar fasting 336.5 70 -
110
 Blood sugar ( PP) 349.4 70 –
130
 BUN 15 4.5 - 21
 Serum creatinine 1.2 0.5 –
1.4

5.  Group II
Ob Values
Normal
(mg/dL) (mg/dL)
 Serum t Cholesterol 175.1 130 -
199
 Serum HDL 54.8 35 -
80
 Serum TG 118.4 40 -
165
 Serum VLDL 23.7 6 -
38

6. Clinical Parameters
 Chest pain
 Vomiting
 Dyspnea
 General weakness
 Pain in epigastria
 Advised to go for cardiac profile test
and ECG.

7. Medication

8. Dietary guidelines
As she is Grade II obese she need to be given
20 Kcal / kg IBW
Thus her daily calorie intake should be
20 * 52.4 = 1048 Kcal / day
Total calorie intake of 3 day recall of Mrs. Kusum was 2018 Kcal /
day
As a drastic reduction of
970 kcal / day is not possible in her daily diet
Hence her calorie intake is reduced by 518 Kcal / day
Thus recommended total calorie intake / day is

9. Macronutrient Distribution
 Improving the quality of CHO is the essence of this diet as patient
is diabetic as well as heart patient. It can be improved by giving
complex CHO with low GI.55 – 60 % calories should come from
CHO.
 Quality of protein should be maintained for better assimilation with
50 – 60 % from good BV. Vegetable proteins are preferred as they
are high in fiber, low in fat and provide adequate micronutrients. 15
– 20 % of calories should come from proteins
 Intake of good quality fat i.e. high intake of MUFA coupled with a
low n-6 : n-3 ratio should be emphasized. Since it is weight loss
diet we consider 22 % of energy from fats.
 Sodium intake should be restricted as she has hypertension Food
rich in antioxidants, hypocholesterolemic agents and
phytochemicals protect from CHD. These include: vitamin E and
vitamin C, selenium, garlic

10. Diet Plan

11. Counseling tips
 Limit your intake of foods high in calories or low in nutrition,
including foods like soft drinks and candy that have lots of
sugars.
 Eat enough amounts of grain products, including whole grains
which provide large amounts of fiber, vitamins and complex
carbohydrates.
 Reduce total fat intake. Reduce or avoid saturated fat (ghee)
when possible. Saturated fat raises your cholesterol level.
 Limit the amount of salt (sodium chloride) you eat.
 Maintain your ideal body weight by exercising regularly. For
example, a brisk walk for at least 30 minutes a day, aerobic

12.  Get regular medical
checkups.
 Control your blood
pressure.
 Check your cholesterol.
 Don’t smoke.
 Exercise regularly.
 Maintain a healthy weight.
 Eat a heart-healthy diet.
 Manage stress.

13. Get info from: info@justforhearts.org
Helpline Number: 09266802992
Skype Id: justforhearts
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