Kiana Shurts

Pregnancy Project
Winter 2016
PART I (Complete Sections I V):

I. Identifying data (1 point)

A. Description of the individual (including lifestyle - impoverished student, affluent lawyers wife,
busy, etc.)
Senior at BYU-I. Student teaching 7th Grade. Teaching Math

II. Health history (10 points)

A. Age; if teenager also include age at menarche

23 years old

B. Previous obstetrical history, including:

(1) Parity and outcome- one- current
(2) Interconceptual period (if applicable)- NA
(3) Birth weights of previous infants (if applicable) -NA
(4) Childrens ages (if applicable)- NA
(5) Lactation experience (always applicable)- Chest has grown

C. Estimated delivery date- July 2nd

D. Laboratory data, if known - hematocrit, hemoglobin= Everything is normal

E. Any illnesses/sicknesses/chronic conditions- Mono Senior Year of High School. Has some flares

F. Cigarette, drug, alcohol use- NONE

G. Previous nutritional deficiencies (prior to pregnancy)- sometime low in Fe

H. Use of medications or supplements (prior to pregnancy)- multivitamins

I. Exercise/activity (prior to pregnancy and currently)- Sedentary both

J. Allergies, other food intolerances- NONE

III. Nutritional assessment (10 points)

A. Obtain a 24-hour recall from your subject. Enter her diet into ChooseMyPlates SuperTracker.
For this section, INCLUDE 3 REPORTS FROM SuperTracker WITH PART I:
(1) Food Group and Calories Report
(2) Nutrients Report
 (3) Meal Summary Report

20 weeks at 2/11/17

CamiHansen's Food Groups and

Calories Report 02/15/17 - 02/15/17
Your plan is based on a 2400 Calorie allowance during your 2nd
trimester of pregnancy.

Food Groups Target Average Status

Eaten
Grains 8 ounce(s) 12 ounce(s) Over
Whole Grains 4 ounce(s) 1 ounce(s) Under
Refined Grains 4 ounce(s) 11 ounce(s) Over
Vegetables 3 cup(s) 1 cup(s) Under
Dark Green 2 cup(s)/week cup(s) Under
Red & Orange 6 cup(s)/week cup(s) Under
Beans & Peas 2 cup(s)/week 0 cup(s) Under
Starchy 6 cup(s)/week 0 cup(s) Under
Other 5 cup(s)/week 0 cup(s) Under
Fruits 2 cup(s) 1 cup(s) Under
Whole Fruit No Specific 1 cup(s) No
Target Specific
Target
Fruit Juice No Specific 0 cup(s) No
Target Specific
Target
Dairy 3 cup(s) 2 cup(s) Under
Milk & Yogurt No Specific 1 cup(s) No
Target Specific
Target
Cheese No Specific 1 cup(s) No
Target Specific
Target
Protein Foods 6 ounce(s) 5 ounce(s) Under
 Seafood 10 0 ounce(s) Under
ounce(s)/week
Meat, Poultry & No Specific 3 ounce(s) No
Eggs Target Specific
Target
Nuts, Seeds & Soy No Specific 1 ounce(s) No
Target Specific
Target
Oils 7 teaspoon 4 teaspoon Under

Limits Limit Average Status

Eaten
Total Calories 2400 Calories 2145 OK
Calories
Added Sugars < 240 Calories 156 Calories OK
Saturated Fat < 240 Calories 283 Calories Over
Note: If you ate Beans & Peas and chose "Count as Protein Foods
instead," they will be included in the Nuts, Seeds & Soy subgroup.

CamiHansen's Nutrients Report 02/15/17 -

02/15/17
Your plan is based on a 2400 Calorie allowance during your 2nd trimester of
pregnancy.

Nutrients Target Average Eaten Status

Total Calories 2400 Calories 2145 Calories OK
Protein (g)*** 71 g 95 g OK
Protein (% Calories)*** 10 - 35% 18% Calories OK
Calories
Carbohydrate (g)*** 175 g 260 g OK
Carbohydrate (% Calories)*** 45 - 65% 48% Calories OK
Calories
Dietary Fiber 28 g 22 g Under
Total Sugars No Daily Target 91 g No Daily Target
or Limit or Limit
Added Sugars < 60 g 39 g OK
Total Fat 20 - 35% 35% Calories OK
Calories
Saturated Fat < 10% Calories 13% Calories Over
Polyunsaturated Fat No Daily Target 6% Calories No Daily Target
or Limit or Limit
Monounsaturated Fat No Daily Target 12% Calories No Daily Target
or Limit or Limit
Linoleic Acid (g)*** 13 g 14 g OK
Linoleic Acid (% Calories)*** 5 - 10% Calories 6% Calories OK
-Linolenic Acid (% 0.6 - 1.2% 0.4% Calories Under
Calories)*** Calories
-Linolenic Acid (g)*** 1.4 g 0.9 g Under
Omega 3 - EPA No Daily Target 2 mg No Daily Target
or Limit or Limit
Omega 3 - DHA No Daily Target 6 mg No Daily Target
or Limit or Limit
Cholesterol < 300 mg 164 mg OK

Minerals Target Average Eaten Status

Calcium 1000 mg 1270 mg OK
Potassium 4700 mg 2531 mg Under
Sodium** < 2300 mg 3417 mg Over
Copper 1000 g 1122 g OK
Iron 27 mg 15 mg Under
Magnesium 350 mg 290 mg Under
Phosphorus 700 mg 1549 mg OK
Selenium 60 g 121 g OK
Zinc 11 mg 11 mg OK

Vitamins Target Average Eaten Status

Vitamin A 770 g RAE 598 g RAE Under
Vitamin B6 1.9 mg 1.2 mg Under
Vitamin B12 2.6 g 4.0 g OK
Vitamin C 85 mg 160 mg OK
Vitamin D 15 g 4 g Under
Vitamin E 15 mg AT 9 mg AT Under
Vitamin K 90 g 197 g OK
Folate 600 g DFE 796 g DFE OK
Thiamin 1.4 mg 2.1 mg OK
Riboflavin 1.4 mg 2.2 mg OK
Niacin 18 mg 24 mg OK
Choline 450 mg 263 mg Under
Information about dietary supplements.
*** Nutrients that appear twice (protein, carbohydrate, linoleic acid, and -linolenic acid) have two separate
recommendations:

1) Amount eaten (in grams) compared to your minimum recommended intake.

2) Percent of Calories eaten from that nutrient compared to the recommended range.

You may see different messages in the status column for these 2 different recommendations.

CamiHansen's Meals
Your plan is based on a 2400 Calorie allowance during your 2nd
trimester of pregnancy.

Date Breakfast Lunch Dinner Snacks

02/15/17 1 medium (3- 1 regular slice mini EMPTY

3/4" across) Bread, 100% baguette
Donuts, raised whole wheat (about 9" long)
(glazed) Bread, French
or Vienna

1 muffin 1 slice (1 oz) 1 brownie (2"

English muffin Cheddar square)
cheese Brownie, no
icing

8 fluid 1 single serving cup Cheese,

ounce(s) Milk, bag (1 oz) cottage, low fat
reduced fat Cracker, cheese (1-2% fat)
(2%) (Cheez-its,
Cheese Nips,
Goldfish)

1 medium (2- 2 slice Ham, slice (1 oz)

5/8" across) luncheon meat, Cheese,
Orange, raw prepackaged or Mozzarella,
deli part skim

1 tablespoon 1 medium (2- medium

Peanut butter, 5/8" across) patty (3-1/2 per
creamy Orange, raw pound of raw
meat) Ground
beef, less than
80% lean,
cooked

1 single serving 1 small scoop

bag (1 oz) Ice cream,
Tortilla chips regular,
(Tostitos, chocolate
Doritos)

2 cup, mixed
greens
Romaine
lettuce, raw

medium
whole (2-3/5"
across)
Tomato, raw
B. SUMMARIZE:
(1a) Your subjects macronutrient distributions (%)
CHO: 48%
Protein: 18%
Fat: 35%
(1b) whether the percentages are appropriate for pregnancy based on macronutrient
recommendations
Her percentages are appropriate. With carbohydrates and protein consumption, she is
average. Her total fat intake is right at the recommended maximum and could be lowered.
(2a) The number of MyPlate food group equivalents your subject consumed based on her
actual intake
My subject consumed ten food group equivalents, which shows that she has a balanced
diet.
(2b) how she is meeting (or not meeting) her personalized MyPlate food group
recommended levels.
Even though she ate from a variety of different food groups, my subject did not meet the
daily recommendation for most of them. In fact, she was under in all vegetables, fruits,
dairy, protein and oils. She did overconsume on refined grains and saturated fats.
(3a) Your subjects actual vitamin and mineral intake and (3b) how it compares to vitamin
and mineral DRIs for pregnancy (i.e. is her diet high or low in any vitamins and minerals).
Minerals
Calcium: 1270 mg----------------- ok
Potassium: 2531------------------ UNDER
Sodium: 3417----------------------- OVER
Copper: 1122 ug------------------- ok
Iron: 15 mg ------------------------ UNDER
Magnesium: 290 mg-------------- UNDER
Phosphorus: 1549 mg------------ ok
Selenium: 121 ug------------------ ok
Zinc: 11 mg ------------------------ ok
Vitamins
Vitamin A: 598 ug RAE----------- UNDER
B6: 1.2 mg ------------------------- UNDER
B12: 4.0 ug ------------------------ ok
C: 160 mg -------------------------- ok
D: 4 ug ------------------------------ UNDER
E: 9 mg AT ------------------------- UNDER
K: 197 ug -------------------------- ok
Folate: 796 ug DFE---------------- ok
Thiamin: 2.1 mg ----------------- ok
Riboflavin: 2.2 mg --------------- ok
Niacin: 24 mg --------------------- ok
Choline: 263 mg ---------------- UNDER
Overall, my subject, Cami, had adequate amounts of most vitamins and minerals. These results are
based on her food consumption only. She also takes daily vitamin and prenatal.

C. Use of food assistance programs such as WIC, SNAP, food bank, church resources, etc. - none
 D. Current use of prenatal or vitamin/mineral supplements- 1 prenatal in the morning and a
probiotic

E. Estimated percentage of income spent on food- 15%

F. What are your subjects cooking and eating habits?

Breakfast: usually toast and peanut butter, with some sort of dairy (milk or
yogurt)
(1) Stays away from cold cereal because it makes her feel sick.
Lunch: sack lunch- sandwich apple, crackers
Dinner: home-cooked

IV. Weight graphed (4 points)

A. State:
(1) Pre-pregnancy weight (lbs or kg)-140 lb now 149lb
(2) Height (in or cm)- 66 in
(3) Pre-pregnancy Body Mass Index (BMI). 22.6
 B. Plot Weight Gain: Using the Baby Your Baby charts (posted on the BYU Learning
Suite), plot your subjects weight gain on the graph INCLUDE PLOTTED WEIGHT
GAIN CHART WITH PART I.

C. Interpret Weight Gain: Compare actual weight gain to expected weight gain
according to pre-pregnancy BMI. Is your subject gaining too much weight? Not
enough weight? Within the recommended range?
Cami is within recommended weight range.

V. Nutritional status evaluation and recommendations (15 points)

 A. Summarize (1-2 paragraphs) what you think are the most significant nutritional risk factors
present in this pregnancy, and explain how the subject could change her diet to reduce this
risk.
Overall, Cami is getting a good variety of food groups throughout her day. However, there are some
things that have yellow flags that could be addressed to prevent any further complications. From her 24-
hour recall, I calculated that Camis iron levels are low. Her overall recommendation is 27 mg per day. I
recorded a total of 15 mg that day. Iron is crucial during pregnancy to make new blood cells for the fetus
and to carry oxygen through the blood. Cami is also low on Magnesium. Her recommended daily intake is
350 mg and she consumed 290 mg. This is low but its not extremely low, so by taking her prenatal, she
should be able to reach the recommended 350 mg. I also noticed that her Vitamin D levels were
significantly low. She consumed a total of 4 ug and is recommended to have 15 ug per day. Most women
are deficient in vitamin D during pregnancy and by taking a prenatal, which has around 400 IU, Camis
vitamin D levels should reach her recommended amount.
Looking at Camis food group consumption, she is under-consuming in most categories, except for
Grains. In the Grains group, there is a category for whole grains and refined grains; 11 of the 12 ounces of
grains Cami consumed were refined grains. In order to get some whole grain into her diet, Cami could
switch out some of her bread options, such as the English muffin, for a whole grain bread. The food group I
am most concerned about are the vegetables. Cami consumed about a cup of vegetables and she needs
to consume around 3 cups a day. Some way she could get more vegetables into her diet would be to add
them to smoothies, make them a side at a meal, or eat them for snacks.
B. Explain (1-2 paragraphs) any recommendations, suggestions, and education you plan to
give this subject and rationale.
Overall, I suggest to Cami that she eat more fruits and vegetables on a daily basis. By doing this, her
vitamins and minerals, such as folate, fiber, vitamin E, A, B6, and potassium will all increase. If she
has a problem consuming more fruits and vegetables, she could take a multivitamin. Along with not
getting enough fruits and vegetables, Cami also didnt quite reach her calorie recommendation. I
would suggest that she starts eating a healthy snack in between meals in order to reach her calorie
goal. Some snacks that would be appropriate are: carrots and hummus, raw vegetables and
dressing, apple and peanut butter, orange, crackers and cheese, etc. Cami is doing very well overall,
however, by following through on some of these suggestions, Camis nutrient intake could be
enhanced.
PART II (Complete Section I II):

I. Education (5 points): Provide your subject with the recommendations/advice you suggested in Part I
(after you review the instructors comments). Ideally, this should be done in-person (but phone is
acceptable too). Summarize (1-2 paragraphs) what you discussed with your subject.

Overall, Cami is very healthy; she is at a healthy pregnancy weight and is eating a balanced diet. While
talking to Cami, I realized I mis-interpreted her when she said told me about her vitamin supplement
intake. I reported that she was taking a daily multivitamin as well as her daily prenatals, when in fact;
Cami was only taking her prenatal vitamins. I realize now that she her prenatal is her source of daily
multivitamin and I no longer need to suggest to her to take a multivitamin. I showed Cami her
weight-gain chart and let her know that she is in a healthy weight. However, because of her 24-hour
recall and what she reported she usually eats, I did suggest to her some different, easy, and simple
food combinations that could increase her variety of foods. I also suggested to her to replace some of
her white flour breads with whole grain in order to increase her consumption of complex
carbohydrates. Showing Cami other possibilities of foods she can eat could help her when her
pregnancy continues and her appetites/cravings change.

II. Reflection (5 points): Write 1-2 paragraphs about your overall impressions of how your subject
received your advice (e.g., do you think she will follow your advice? Why or why not?). Also describe
how you could have improved the education you gave.

Cami was very considerate and open to the suggestions I gave her. When I mentioned that her
variety of foods in each food group was low, she agreed, and I could see that she was open to
suggestions. When I gave her suggestions of what food combinations make great portable snacks,
she was very enthused. She commented that this was a great reminder for her and that she was
going to start buying new foods to bring with her to work. Overall, I didnt have many suggestions to
give to Cami and the suggestions I gave her, she took without offense.