Case study: busy accountant with metabolic syndrome

Harry has metabolic syndrome, which places him at risk for cardiovascular disease. As outlined in this case study, he needs to lose weight and take some exercise.

Name Harry
Age 52 years

Problem

In the past three years, Harry has gained 5.5kg (12lb) and has now been told by his GP that he has raised blood pressure and high LDL-cholesterol and triglyceride levels. He does not take any medication or smoke. He drinks three large cups of coffee each morning and a litre (2 pints) of beer each evening.

Lifestyle

Harry is an accountant and has a high level of stress at work and at home. Work commitments mean he often orders a pizza for lunch and eats at his desk. After work and his commute home, Harry is too tired to exercise. He often eats a steak for supper and snacks on ice cream and crisps at night. He rarely eats fruit.

Advice

Harry has metabolic syndrome, which places him at risk for cardiovascular disease. He needs to lose weight and take some exercise. Based on blood tests, his goal is to lower total cholesterol, LDL cholesterol, and triglycerides, and to raise his level of HDL cholesterol. He can achieve this by following the Therapeutic Lifestyle Change Diet and reducing his total intake of calories.

Harry's diet is high in saturated fat and cholesterol. He should substitute monounsaturated fat and omega-3 fatty acids for saturated fat, cut back on his portion sizes, and increase his activity level. Eating more fruits and vegetables, whole grains, pulses, low- or reduced-fat dairy products, fish, chicken breast without skin, and lean meats will help. If he likes eggs, he can include two in his diet each week.

For breakfast, Harry could have porridge with skimmed milk and an orange. For lunch, he could order a salmon or turkey salad sandwich or have two slices of vegetable pizza. For dinner, he could have fish and chicken more often and limit red meat to less than once a week.

Harry could increase his daily intake of soluble fibre from oats, oat bran, pulses, and fruits. Cholesterol-lowering margarines could replace other spreads to further lower his LDL-cholesterol levels. He may also benefit from reducing his intake of salt.

Lisa Hark, PhD RD & Dr Darwin Deen

Posted 14.02.2011

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See more in the dossier: Nutrition for cardiovascular disease