Nutrition assessment and evaluation using a fertility-focused case

Please continue to use the feedback from the instructor that I gave you lastweek if it pertains. Review the case study below, then answer the following questions in an APA-formatLinks to an external site. document. Please present your responses in paragraph form using appropriate APA-style headings and in-text citations. Case Study: Emma is a 25-year-old woman who is focused on improving her health and preparing her body for pregnancy in the near future. She leads a generally healthy lifestyle, doing her best to maintain a consistent exercise routine, though she reports this is sometimes difficult to keep up with her busy job as a traveling sales representative. Emma does not smoke and consumes between one and two glasses of white wine every night with dinner with her partner when she is not on the road for work. Emma does have a history of irregular menstrual cycles and anemia, which she is worried might affect her fertility. Based on the recommendation of her gynecologist, she is seeking guidance on optimizing her health to enhance her chances of conceiving and having a healthy pregnancy. Emma expresses that she knows nutrition will be important if she is able to get pregnant and so she is interested in learning more about nutrition, supplementation, and lifestyle modifications that may support her reproductive health and overall well-being. Emma enjoys cooking but does not feel very confident in the kitchen, so she reports her meals are typically very simple. She does follow up with her primary care provider routinely and she recently completed lab work as a baseline for her care. Progesterone: Low-normal Thyroid Function Tests: Normal Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH): Normal Complete Blood Count (CBC): Hemoglobin 10g/dL, hematocrit 35%, mean corpuscular volume (MCV) normal Fasting Blood Glucose: 100 mg/dL STI/STD Screening and Pelvic Ultrasound: Normal Allergies: Peanuts Medications and Supplements: Only consumes elderberry syrup occasionally during the winter months. 24 Hour Diet Recall: Breakfast: Sourdough toast with almond butter and banana (though she reports often consuming cinnamon oatmeal with blueberries or strawberries on a busy morning) Lunch: Tuna salad sandwich on sourdough bread with carrots and celery (though she reports sometimes relying on fast food when she is on the road for work as she struggles with eating healthy while traveling) Grilled balsamic chicken with rice and potatoes (though she reports sometimes relying on an almond butter and jelly or a grilled cheese sandwich when working late) Snacks and Dessert: Pretzels and apples with almond butter (though she reports often snacking on popcorn while driving) 3. Please address the following questions in an APA formatLinks to an external site. document: What is your interpretation of Emma's presentation based upon the provided data in relation to her primary goals and concerns? What could be contributing to these results? What dietary and/or supplement recommendations might you make for this client, and how do they specifically relate to her symptoms, goals, and lab findings? Be specific when describing supplements, including the type, form, and dosage where appropriate, and provide a rationale supported by current research. What are some examples of challenges which might hinder Emma's success with your recommendations? How might you work together to overcome these barriers? What are three to five SMART goals you would set for Emma between now and your next follow up session? What lifestyle recommendations, clinical or professional referrals, and/or follow up lab testing might you recommend for Emma and why do you feel these would be supportive? Please be specific. References to use if the reference is not relevant, please do not use them or if you find a reference better you can use a couple of your own: Noland, D., Drisko, J., & Wagner, L. (2020). Integrative and functional medical nutrition therapy: Principles and practices. Humana Press. Chapter 32 - Nutritional Influences on Reproduction: A Functional Approach Rakel, D., & Minichiello, V. (Eds.). (2022). Integrative medicine (5th ed.). Elsevier. Chapter 53 - Preconception Counseling and Fertility Chapter 37 - Polycystic Ovarian Syndrome Skoracka K, Ratajczak AE, Rychter AM, Dobrowolska A, Krela-Kaźmierczak I. Female Fertility and the Nutritional Approach: The Most Essential Aspects. Adv Nutr. 2021 Dec 1;12(6):2372-2386. doi: 10.1093/advances/nmab068. PMID: 34139003; PMCID: PMC8634384. Calcaterra, V., Verduci, E., Cena, H., Magenes, V. C., Todisco, C. F., Tenuta, E., Gregorio, C., De Giuseppe, R., Bosetti, A., Di Profio, E., & Zuccotti, G. (2021). Polycystic Ovary Syndrome in Insulin-Resistant Adolescents with Obesity: The Role of Nutrition Therapy and Food Supplements as a Strategy to Protect Fertility. Nutrients, 13(6), 1848. https://doi(dot)org/10.3390/nu13061848 Rolfo A, Nuzzo AM, De Amicis R, Moretti L, Bertoli S, Leone A. Fetal-Maternal Exposure to Endocrine Disruptors: Correlation with Diet Intake and Pregnancy Outcomes. Nutrients. 2020 Jun 11;12(6):1744. doi: 10.3390/nu12061744. PMID: 32545151; PMCID: PMC7353272. Skoracka K, Eder P, Łykowska-Szuber L, Dobrowolska A, Krela-Kaźmierczak I. Diet and Nutritional Factors in Male (In)fertility-Underestimated Factors. J Clin Med. 2020 May 9;9(5):1400. doi: 10.3390/jcm9051400. PMID: 32397485; PMCID: PMC7291266. Pecora G, Sciarra F, Gangitano E, Venneri MA. How Food Choices Impact on Male Fertility. Curr Nutr Rep. 2023 Dec;12(4):864-876. doi: 10.1007/s13668-023-00503-x. Epub 2023 Oct 20. PMID: 37861951; PMCID: PMC10766669.