Barbara’s case

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Discussion Topic

Barbara is a 72-year-old woman with a “Type A” personality who was diagnosed with a peptic ulcer more than 40 years ago. At that time, her doctor told her to follow a bland diet and eat three meals per day with three snacks per day of whole milk to “quiet” her stomach. She meticulously complied with the diet to the point of becoming obsessive about eating anything that may not be “allowed.” She lost 15 pounds by following the bland diet because her intake was so restricted. She recently began experiencing ulcer symptoms and has put herself back on the bland diet, convinced it is necessary in order to recover from her ulcer. 

Barbara’s 1600-calorie My Plate plan calls for 1.5 cups of fruit, 2 cups of vegetables, 5 grains, 5 oz of meat/beans, 3 cups of milk, and 5 teaspoons of oils.

Yesterday, she ate the following:

Breakfast: 1 poached egg; 2 slices dry white toast; 1 cup whole milk

Morning Snack: 1 cup whole milk

Lunch: ¾ cup cottage cheese with½ cup canned peaches

Afternoon Snack: 1 cup whole milk

Dinner: 3 oz boiled chicken; ½ cup boiled plain potatoes; ½ cup boiled green beans; ½ cup gelatin

Evening Snack: 1 cup whole milk

1. What food groups is she undereating? Overeating?
2. What are the potential nutritional consequences of her current diet?
3. What other information would be helpful for you to know in dealing with Barbara?
4. Barbara clearly wants to be on a bland diet; what would you tell her about diet recommendations for PUD? What recommendations would you make to improve her symptoms and meet her nutritional requirements while respecting her need to follow a “diet”?