Madeleine is a 42 year-old pre-menopausal Caucasian female who weighs 138 pounds at 5 feet 7 inches tall. Her mom recent

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Madeleine is a 42 year-old pre-menopausal Caucasian female who
weighs 138 pounds at 5 feet 7 inches tall. Her mom recently died
after a long stay in a nursing home. Her mom fell a year ago and
broke her hip and was never able to fully recover. Madeleine’s
mother had osteoporosis and she is now concerned that she will also
develop osteoporosis after menopause. She has never been a big milk
drinker because she’s lactose intolerant and does not like the
taste of dairy. For the past 6 months, she’s been taking 1 - 800 mg
calcium carbonate supplements per day plus a women’s one-a-day
multivitamin that contains 100% of the daily AI for calcium. In
addition, she has been consuming more lactose free milk to make up
for poor calcium uptake during her young adult years.
Madeleine’s typical diet consists of cereals, fruits, and
vegetables, pasta, rice, and yogurts and cheeses that do not
aggravate her lactose intolerance. She is not a big meat eater, but
she enjoys the occasional fish and seafood.
For the past 3 weeks, Madeleine has been having pain in her
lower back and has passed some blood in her urine. In addition,
she’s also been short of breath, fatigued, and has been having
heart palpitations. Below is a typical day of intake and her
dietary analysis:
Breakfast:
Toast with butter and jam
Yogurt with strawberries
Coffee
Supplements Calcium + Multi-vitamin
Snack:
Nutrigrain granola bar
Coffee
Lactaid
Lunch:
Spinach salad with mozzarella and tomatoes
Mixed fruit salad
Hot tea with honey and lemon and 1 glass Lactaid
Dinner:
Grilled snapper
Rice
Mixed veggies
1 glass of Lactaid
Snack:
Yogurt and a handful of granola
Dietary analysis (including supplements): Carbohydrate 59%;
Protein 14%, Fat 27%
Nutrient/Item
DRI
Intake
% DRI
Nutrient/Item
DRI
Intake
%DRI
Kilocalories
2061.4 kcal
1675 kcal
81
Vitamin C
90 mg
200 mg
222
Protein
50.2
58.6
116.8
Vitamin D
5 mcg
6 mcg
120
Dietary fiber
38 g
30
80
Vitamin A(RAE)
900.41 mcg
1200 mcg
133.3
Alcohol
No rec
0
--
Vitamin E
15 mg
18 mg
120
Thiamin
1.2 mg
1.0 mg
83
Calcium
1000 mg
4800 mg
480
Riboflavin
1.3 mg
1.6 mg
123
Iron
8 mg
3 mg
38
Niacin
16 mg
18 mg
113
Magnesium
400 mg
380 mg
95
Vitamin B6
1.3 mg
1.2 mg
92
Potassium
4700 mg
4800 mg
102
Vitamin B12
2.4 mcg
2.2 mcg
92
Zinc
11 mg
9 mg
82
Folate (DFE)
400 mcg
600 mcg
150
Sodium
1500 mg
2700 mg
180
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