Reference no: EM134020586

Question

Sofia

Sofia is a 27-year-old female who has developed significant fatigue. She says that she feels tired almost every day, despite getting adequate amounts of sleep. Drinking coffee helps, but she limits herself to one cup in the morning. She does not feel anxious or depressed and states that overall, her stress level is "not that high." She loves her job working as an administrative assistant for an advertising agency and is newly engaged to her longtime boyfriend. She has maintained a healthy plant-based vegetarian diet for the past three years, avoiding all animal-derived foods. She is not on any medication but takes a B vitamin complex and a calcium supplement with Vitamin D daily. Her body mass index is 18.7. She exercises thrice a week for about 40-60 minutes, mostly running, hiking, and sometimes biking. She will lift weights occasionally as well. During exercise, she says she notices a little shortness of breath, but nothing concerning. Her menstrual cycles have been regular, but noticeably heavier over the past year. She also notices that her hair is shedding a lot, but can't tell if it is more than normal; She says that she sees more in the shower drain and her hair brush.

1. What mineral deficiency does Sofia most likely have? Be sure to explain why she may have developed this deficiency and what symptoms are associated.

2. If she went to see her doctor, would this deficiency show up in her bloodwork? What blood parameters would most likely be affected?

3. What advice would you give Sofia to help correct her deficiency and how should she prevent this in the future?

Brian

Brian is a 54-year-old male who is trying to get healthier. He has a strong family history of hypertension and heart disease in his family and he lost his father to a heart attack last year. His diet is what most consider to be a Standard American Diet and includes eating fast food maybe once or twice a week. He is happily married, has 3 children, and works as a contract lawyer. He describes his job as "very stressful" and often works 50+ hours per week. He consumes 2 alcoholic beverages 4 times a week, mostly Scotch, but sometimes wine or beer. Brian is overweight, with a BMI of 29.8 and rarely finds the time to exercise.

At his doctor's visit 6 months ago, he was diagnosed with hypertension and mixed hyperlipidemia and prescribed medications. His blood pressure is now well controlled. His total and LDL cholesterol levels have dropped significantly to normal with the use of a statin drug, but for some reason, his triglycerides (simple blood fats) remain elevated on his blood tests. The normal range for triglycerides is below 150mg/dL and his is 203 mg/dL. Although this is an improvement for him, it is still not optimal. He currently does not take any natural supplements but is open to taking something if it will help.

1. What health risks does a high triglyceride level pose for Brian? What in his diet would contribute to elevations in his triglycerides?

2. In addition to recommending changes in his diet and exercise habits, what accessory nutrient do you find to be the most indicated here for helping Brian reduce his elevated triglycerides?

3. What has been proven to be effective? Be sure to cite your scientific source(s).