Answer to Question 1
Current recommendations for treatment of hyperlipidemia use the Therapeutic Lifestyle Change Diet and the DASH diet recommendations.
<30 total kcal from fat
<7 from saturated fat
<200 mg cholesterol
<2400 mg sodium
20-30 g fiber per day
The DASH diet encourages 10-12 servings of fruits and vegetables in order to provide higher potassium, magnesium, and calcium in the diet with a reduced sodium intake.
Mrs. Washington's diet provides:
Nutrient Recommended amounts (based on 2000 kcal/day) Mrs. Washington's
Fat <30 of total kcal 33
Saturated fat <7 10
Cholesterol <200 mg 181 mg
Calcium 1240 mg 707 mg
Potassium 4700 mg 3452 mg
Sodium <2400 mg 2712 mg
Mrs. Washinton's diet is really pretty close to the recommendations of both the TLC and DASH diets.
Her diet is slightly high in fat, low in potassium, high in sodium, low in calcium, and high in saturated fat.
Increasing the total quantity of fruits and vegetables will assist to reduce total energy and sodium intake with lower-fat food choices and increase potassium at the same time. Increasing her dairy intake through low-fat milk and yogurt can help improve her calcium intake while avoiding saturated fats that come from cheese sources.
Yes, these recommendations should apply to Mrs. Washington during this acute phase.
Answer to Question 2
Oral intake may be decreased during the immediate post-MI period due to pain, anxiety, fatigue, and shortness of breath.
Initial oral intake may be limited to clear liquids without caffeine to prevent arrhythmias and decrease risk of vomiting or aspiration.
Oral diets usually progress from liquids to soft, easily chewed foods with small, frequent meals.
Goals of nutrition therapy are individualized according to the patient's risk factors as he/she stabilizes and should follow the Therapeutic Lifestyle Changes dietary recommendations.