PROBLEM: Consider the case of Hiroshi Tanaka.
Hiroshi Tanaka is a 29-year-old computer specialist who lives and
works in Sendai. Mr Tanaka says he is "health-conscious"; he reads
many different magazines and Internet sites to stay current with the
latest information about staying trim, energetic and healthy.
However, Mr Tanaka is also very busy with his computer business and
he's finding it difficult to follow all the recent information on good
eating and healthy lifestyle patterns. Because of his confusion, Mr
Tanaka has come to your office since he feels he needs expert
counselling and he wants your advice about what he should do in the
future.
One problem is that he is very confused about what would be the
recommended daily amounts (RDA) of vitamins and minerals for a man his
age. He is also confused about different information he has been
reading about protein and minerals. "What's the real difference
between carbohydrates and fats?" he asks, "and if I pay attention to
eating red meat which has lots of high protein, won't that be good
enough?"
When you talk to Mr Tanaka you find there are other issues that may be
clinically relevant. Since he is busy six and sometimes seven days a
week, he doesn't have time to eat breakfast most mornings, and he also
finds he needs to intake fast food like hamburgers, cheeseburgers or
udon at lunch and dinner. He also tells you that he relies on vitamin
supplements which he takes with four or five cups of coffee in the
morning and colas in the afternoon. He admits that he really hates
most vegetables, but "I get good nutrition from the vitamin
supplements I take, and I when I can, I eat a lot of meat, beef and
pork mostly." He knows he should
be eating foods that are rich in fiber, "like most Japanese, I get my
fiber from eating udon and rice, and that's all I need to think about,
right?"
More troubling, perhaps, Mr Tanaka has been feeling lots of pressure at work lately, and most
recently he finds it hard to relax even after work. Mr Tanaka does not like to exercise,
"but even a young man needs
to run to keep his weight down -- that's the only reason I do it!"
Since Mr Tanaka is so busy, he exercises for only about a half an hour
once a week, and yet he feels this is enough to keep him from becoming
fat.
His medical records indicate a few other issues. Both his grandfather
and father have diabetes. His mother is currently ill with a critical
heart condition. Mr Tanaka's LDL level is measured at 172. He tells
you he's surprised by that measurement since he doesn't eat sweet
foods, and he wants you to tell him what he can do to lower his
LDL.
All together, there a number of serious issues for you and Mr Tanaka
to review and talk about. Please give Mr Tanaka basic advice with
some detailed examples regarding the kind of diet he should consider
adopting. And suggest reasons for him to change both his diet and
other lifestyle habits. Click
BELOW for case analyses from second-year students at Miyazaki Medical
College.