PROBLEM: Consider the case of Mr and Mrs M:
Mr and Mrs Mine (M) are both in their late twenties. Married for only two years, they plan on continuing their work careers and have decided to put off having children for the next four or five years. Because they work hard, neither Mr nor Mrs M are very careful about what they eat. Monday through Saturday they usually skip breakfast or if there's time, they'll fry some food left over from the day before. At lunch Mrs M eats a simple meal, usually a bowl of rice with some meat (usually beef or pork) and a sweet dessert, cake, cookies or ice cream. Mr M's lunch is usually a hamburger or fried chicken or fried fish.
Since Mr M works late, Mrs M eats her dinner alone, and very often her dinner is a combination of snack food and sandwiches -- she especially likes cheese or eggs and butter or margarine on her bread. When Mr M comes home late at night, both Mr and Mrs M share fast food that Mr M picks up on his way from the office -- pizza, yakitori or Chinese noodles with eggs, pork and chicken.
Mr and Mrs M have asked for your advice about their unbalanced diets. Since there are several food categories missing from their daily food intake, you need to explain what kinds of vitamins and other nutrition they need and why. Further, there are early signs that Mr and Mrs M are not in perfect health. Mr M has high blood pressure and occasionally experiences angina chest pains. He tells you he has no opportunity to do regular exercise, and you observe that he is a heavy smoker, as well. Mr M has low levels of HDL but his LDL level is 170.
Mrs M, on the other hand, has both high HDL and LDL levels; her LDL is 165. Mrs M is more concerned about her appearance than her health. She cannot understand, for example, why she is 10 kilos overweight, since she eats only two meals a day. But even if she continues with her dietary pattern and her lack of exercise, she does not think she will gain more weight. (She tells you that most women in her family are thin, but, more important, you also learn that several aunts and her mother have developed complications with various cancers, including cancer of the breast.)
With regard to their daily eating habits, both Mr and Mrs M need good information about what and how to change and they need to be educated about why these changes are important. Several issues are common problems for both these patients, but there are also specific risks for Mr M and other risks for Mrs M. Please help them to better understand what they must do to improve their prospects for a healthier future.