Male Case Study


The Client

• 66-year-old male
  
• 5'10"
  
• 248 pounds
  

His Health Concerns

• High cholesterol and blood pressure
  
• Poor strength, poor cardiovascular fitness, very poor balance and very poor flexibility
  
• Personal history of minor cardiovascular incidents (stents, angioplasty)
  
• Personal history of orthopedic injuries (chronic lower back pain, meniscus tear
  and rotator cuff tear)
  
• Taking many supplements (weight loss, general health, cholesterol lowering and muscle building)
  

Training Issues Before Engagement

The subject had been training with a personal trainer for over two years. He was unable to lose weight, despite exercise and nutrition guidance from his personal trainer. After extensive assessment from Nutrifitness, it became clear that the client:

• Was lifting weights far beneath his ability
  
• Was exercising on an elliptical trainer below his optimum range
  
• Was doing the same resistance exercises in the same order for over two years
  
• Was not incorporating effective balance training during workouts
  
• Was minimally stretching during workouts
  
• Was not addressing lower back pain with core muscle development exercises
  
• Had very poor form on exercises
  
• Was holding breath during lifts leading to serious blood pressure shifts (this potentially dangerous situation had not been monitored by the previous trainer)
  
• Was taking unnecessary supplements (some with potentially dangerous interactions with prescription medications also unmonitored by the previous trainer)
  
• Was experiencing high blood pressure (unmonitored by the previous trainer)
  

Client's Medical Assessment and Assessment of Strength, Flexibility and Balance

The previous trainer had never consulted the subject's physician. Nutrifitness always tires to speak directly with our clients' physicians. In this case, after reviewing the client's lab report and speaking with his doctor, it was revealed that:

• Total and LDL (bad) cholesterol was quite high despite medication
  
• Blood glucose was elevated
  
• Rotator cuff injury occurred during the two-year training (cause not established)
  
• Isolated knee extensions in previous exercise plan were inappropriate (due to untreated meniscus tear)
  

This was followed by tests on the client of his current strength, muscle flexibility, balance and cardiovascular fitness.


Final Work-up and Results

• After completing the assessment, Nutrifitness established a new exercise program with the client.
  
• The cardiovascular portion of the program alternated between elliptical trainer, treadmill walking, walking part of the way to work and weekend bike rides with his grandson. The formal portion (elliptical and treadmill) was increased to a safe, but more effective, level for cardiovascular fitness improvement so that more calories were burned during and after the workout.
  
• Weight training focused on improving core stability, increasing weights to an appropriate level, improving balance and increasing flexibility. A strong emphasis on the importance of monitoring blood pressure, especially during resistance exercise was explained.
  
• Although dietary analysis revealed reasonably good intake of vitamins, minerals, healthy fats, protein, and fiber, there was a slightly elevated caloric intake caused by periods of no food intake followed by large meals. Dietary counseling revealed client often consumes food with no regard for actual hunger, had stress eating issues and a poor body image.
  
• Eating changes included eating more frequent meals of smaller portions and making healthy snacks a regular part of his day. The plan also allowed more freedom with less-ideal snacks by controlling portions. Client was counseled on the importance of health goals rather than weight goals.
  
• Tips were given to the client to help him overcome stress eating and lower calorie eating choices were given if the client felt the need to eat in a stressful situation.
  
• Supplements were discontinued, with one exception, and food recommendations with regard to medications were also made.
  
• After four months with Nutrifitness, client lost seven pounds, increased all fitness parameters and was able to discontinue one blood pressure medication. Recommendations for next physical and blood test include cholesterol, long-term blood sugar analysis and medication review.