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Clinical Case Vignette: Macronutrients

Jun 16, 2018

Mr. Carlson is a man, 52-years of age. He is Caucasian and works as a grocery store manager. His labs show that they were significant for elevated random plasma glucose 166 mg/dL, A1C 7.6% and elevated lipids (TG=175 mg/dL, LDL 148 mg/dL, HDL 38 mg/dL, total cholesterol 221 mg/dL). His physical exam is notable for central abdominal obesity (waist circumference 42”), BP 147/91, HR 72, RR 18, BMI 36 kg/m2, but otherwise normal. He is started on metformin and a dietitian is recommended. The dietitian discusses with him the benefits of medical nutrition therapy on weight, glycemic control, blood pressure, lipid profile, and overall wellbeing. Which following statement regarding macronutrients is true?


Answer: D. Saturated fat should be <7% of total calories

Educational Critique: Saturated fat should be <7% of the total daily calories. Dietary modifications and the composition of carbohydrates/fats/protein should be adjusted to meet the needs and preferences of the individual patients. Carbohydrate monitoring is still a key component for glycemic control. It can occur in the form of carbohydrate counting, estimation based on experience, or educated food choices. Reduced trans fat intake results in a lower LDL and increased HDL.  — American Dietitians Association