• Internal Code :
  • Subject Code : DTN201
  • University : La Trobe University
  • Subject Name : Nutrition

Case Study: Miss Smith Diary

The report is about the case study of Miss Smith and her food intake record and how she can be assisted to reduce weight. The report is going to discuss the discussion of the food intake record concerning different reading obtained after calculating the energy balance of Miss Smith. The report is going to analysing different aspect that related to the Miss Smith case study


Miss Smith was facing the weight issue as she has gained 8kg after her new job that directly leads her BMI to 26.2 which is considered to be the in the category of overweight. The dietary pattern of Miss Smith indicates the fluctuation as there is the uncertainty of the carbohydrate, fat and protein. The unusual pattern of diet can directly increase complication and it is different as there is no nutritional intake balance due to lack of understanding. The food intake should be following the weight and eating frequency to reduce the chances of being overweight that can increase complication (Raynor et al., 2015).

She is very desperate to lose the weight that leads her to join the gym for three nights every week and reduce carbohydrate in the diet. But after calculating the energy balance it was reported to be in negative that indicates that there is an increasing requirement of the energy consumption. The physical activity should be planned according to the energy intake that helps to maintain the energy balance by performing the activity following the intake of energy. The accurate physical activity will help to maintain the nutrient metabolism and it also helps to reduce the increased weight (Westerterp, 2018).

The food intake record of Miss Smith can be biased as it is only reported by the patient and results are estimates as there is decreased trustworthiness of Miss Smith recording. The health image is one of the important facts that can directly affect over or under-reporting. Negative health image leads to underreporting of food intake and positive health image lead to over-reporting of the food intake by the individual. The negative health image leads to a negative thought about the health of the individual on the other hand positive health image lead to confidence and self-esteem about health status (Banna et al., 2014). No the food intake record for three days is not suitable to analyze the individual eating pattern as the result obtained from the 3 days food intake record lead to the unsatisfactory result that hampers.

The food intake record should be of a minimum of 7 days to analyze the accurate food intake record (Ortega et al., 2015). The food intake data of Miss Smith indicate major misbalance and there is a need to manage the nutrition intake. The protein intake should be reduced to reduce from 91 kg to 46 g/day to maintain the balance protein intake to reduce the chances of increased protein content. The food intake record indicates the fat consumption is accurate concerning the Nutrient Reference Values and there is no need for changes. The fibre intake helps the individual to improve health status and there is a need to increase the fibre intake to 25g/day to increase wellbeing.

The nutrient reference value indicates that iron consumption should be 18mg/day to balance the nutrition intake thus there is a requirement to increase the iron consumption. 673mg/day calcium intake is considered to be less when compared to the references value and there is a need to increase the consumption up to 1000mg /day. The high sodium intake can lead to hypertension that can increase complication so the diet should include a maximum of 920 mg/day sodium intake thus sodium intake should be reduced to decrease complication. The accurate energy intake as per the nutrition reference value is 4000 KJ/day to maintain the energy balance but it will also fluctuate concerning the physical activity of the individual (Nutrient Reference Values, 2017).

The certain limitation associated with nutrition references value includes long term assessment is required, uncertainty toward the actual requirement, variability at the individual level and bioavailability of nutrients. Limitation directly decreases the utility of the method for food intake record analysis as it can decrease the chances of success rate (Allen et al., 2019). The limitations that are associated with Miss Smith can include a different dietary requirement, misbalance in nutrition intake and greater energy expenditure. The certain limitation associated with nutrient analysis software include high respondent number can lead to inappropriate food or quantity selection, the patient responds less diligently, limited database, decrease methods to measure the food intake, error while using database and limited foo item.

The software requires further improvement to accurately meet the client requirement and help in food intake analysis (Raatz et al., 2015). The normal fat intake in the normal diet of the individual should be 20-30 per cent and the accurate ratio for unsaturated to saturated is to be 50:50 to maintain the normal requirement of the fat in the body (Dydjow-Bendek & Zagoźdźon, 2020). The food intake record of Miss Smith indicates that there is higher consumption of the unsaturated fatty acid that can increase complication thus balance should be maintained for a healthy lifestyle.

Acceptable Macronutrient Distribution Range helps to set the limit for the consumption of the different compound like carbohydrate, fat and protein which directly reduce the risk for the non-communicable disorder. The acceptable macronutrient distribution range helps to maintain the record for the appropriate nutrient amounts that are used as fuel as they are involved in important functions like growth, metabolism and repair. The intake of macronutrient should be appropriate to a certain level as they are considered to be utilized as fuel to run the body.

Carbohydrate is majorly utilized for energy purpose which is about 70% then fat is utilized it is about 45% and lastly, 23% of the energy contribution is done by protein. The accurate amount of the different nutrients help to maintain the energy balance that is required for body functioning (Lee, et al., 2015). Energy requirements and expenditure equation are utilized to estimate the average energy requirement in dietary intake that helps to maintain the energy balance in the individual. The certain limitation with equation includes utilizing the traditional method, inconsistent with the individual, weight-based prediction and disturbance in the mathematical calculation (Barringer et al., 2018).

The estimating energy requirements and expenditure equation help to provide nutritional support. That utilized multiple aspects including macronutrient, vitamins and mineral with trace element to calculate the accurate nutrient requirement. The nutrient reference value includes certain guidelines which are estimated average requirement, recommended dietary intake, adequate intake, estimated energy requirement and upper level of intake. The Schofield equation is based on the basal metabolic rate of the individual and it is calculated by body mass index. Certain limitations are associated with Nutrient Reference Value it lacks the actual requirement of the individual and leads to a decrease in the bioavailability of the nutrient.

The energy intake of Miss Smith was calculated by utilizing the Schofield that requires the calculation of BMR which was done by an equation which is about 66624k. The BMR is then, multiplied with the physical activity level that is 1.5 to calculate the estimated energy requirements which is calculated as 9936kJ. The estimated energy requirement calculated form the NRV table is about 8400-9600kJ/day that directly differs from Schofield calculations. The average energy balance of Miss Smith is about 1150kJ/day that was calculated after subtraction of the energy expenditure from the energy intake. This indicates that her food intake and physical activity are low when compared to the daily expenditure and if she continues to negative energy balance will help in weight loss.


The evaluation of the individual dietary intake and physical activity is quite difficult to predict and little information about Miss Smith increase difficulty. After joining her new job she was recently gained 8 kg that has increased her concern and she requires assistance to lose weight. The three-day food intake record is not sufficient to analyse the dietary routine of Miss Smith. The negative and positive body image is the mental image of the individual to analyse their health status as healthy or unhealthy. The reframing is required to balance the nutrient that will help her to maintain accurate intake which will support weight loss.

The nutrient intake record was evaluated by analysing different aspects like nutrient intake, energy expenditure and energy intake. Miss Smith has tried multiple aspects to lose her weight like joining the gym for three nights every week and reduce the carbohydrate amount in the diet. After analysing her energy intake and energy expenditure the energy balance was calculated that was about 1150kJ/day. The nutrient reference values help to maintain the accurate nutrient amount. The negative energy balance is revealed to help Miss Smith to reduce the weight that is a major issue faced by her.


Allen, L. H., Carriquiry, A. L. & Murphy, S. P. (2019). Perspective: proposed harmonized nutrient reference values for populations. Advances in Nutrition, 11(3), 469–483,

Banna, J. C., Fialkowski, M. K. & Toewnsend, M. S. (2014). Misreporting of dietary intake affects estimated nutrient intakes in low-income Spanish-speaking women. Journal of the academy of nutrition and dietetics, 115( 7), 1124-1133

Barringer, N.D., Pasiakos, S.M., McClung, H.L. (2018). Prediction equation for estimating total daily energy requirements of special operations personnel. Journal of the International Society of Sports Nutrition, 15(15), 1-9 https://doi.org/10.1186/s12970-018-0219-x

Dydjow-Bendek, D., & Zagoźdźon, P. (2020). Total dietary fats, fatty acids, and omega-3/omega-6 ratio as risk factors of breast cancer in the polish population - a case-control study. In vivo (Athens, Greece), 34(1), 423–431. https://doi.org/10.21873/invivo.11791

Lee, E., Choi, J., Ahn, A., Oh, E., Kweon, H. & Cho, D (2015) Acceptable macronutrient distribution ranges and hypertension. Clinical and Experimental Hypertension, 37(6), 463-467, DOI: 10.3109/10641963.2015.1013116

Nutrient Reference Values. (2017). Introduction. Retreived from: https://www.nrv.gov.au/introduction

Ortega, R, M., Perez-Rodrigo, C. & López-Sobaler, A. (2015). Dietary assessment methods: dietary records. Nutricion hospitalaria. 31. 38-45. 10.3305/nh.2015.31.sup3.8749.

Raatz, S. K., Scheett, A. J., Johnson, L. K. & Jahns, L. (2015). Validity of electronic diet recording nutrient estimates compared to dietitian analysis of diet records: randomized controlled trial. Journal of Medical Internet Research, 17(1):e21

Raynor, H. A., Goff, M. R., Poole, S. A., & Chen, G. (2015). Eating frequency, food intake, and weight: a systematic review of human and animal experimental studies. Frontiers in nutrition, 2(38), 1-19. https://doi.org/10.3389/fnut.2015.00038

Westerterp K. R. (2018). Exercise, energy balance and body composition. European journal of clinical nutrition, 72(9), 1246–1250. https://doi.org/10.1038/s41430-018-0180-4

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