Jose Garcia is a 68 YO male with PMHx of HTN, hypercholesterolemia, pre-diabetes and bilateral knee arthritis. He is currently on blood pressure medications. Medical intake shows a BP 148/88, Fasting Glucose 120, Weight 250, Height 5 feet 6 inches and Waist circumference 45 inches. Jose’s goals are to lose weight and avoid diabetes.

For breakfast, Jose usually gets a buttered roll with coffee when he goes out for the papers. On weekends, Jose’s wife cooks him eggs and pancakes. I recommend Jose to try avocado on toast or whole grain pancakes. Both food options are high in fiber and have good fats to maintain healthy levels of cholesterol. High fiber whole grain pancakes can keep Jose satiated and reduce any cravings he may have in the morning.

Jose usually has a sandwich for lunch and sometimes eat out with his friends. His go to order is steak with fried plantains. For dinner, Jose eats what his wife makes which is usually meat or fish with plantains or rice and beans. I recommend Jose to try the pescatarian diet and have a palm size amount of rice to limit amount of carb intake. Many food in the pescatarian diet are high in fiber and protein such as seeds and nuts. Unlike simple carbohydrates, these food take longer to digest. In the end, Jose can maintain a low calorie intake while satiated. A palm size amount of carbs is a way for Jose to maintain portion control. A person’s palm is generally is good measure of portion size relative to that individual’s body size. If Jose still insists on steak and fried plantains, then Jose can try air fried plantains and see if it can be substituted for fried plantains. Air frying can eliminate added oils and reduce calorie intake. However, Jose should be reminded that how you choose to cook is not the same as what you choose to eat. An air fryer does not make a choice of food healthy.  Jose can enjoy his other delicacies in moderation, but it is high suggested that Jose maintains a low salt and carb diet and try the pescatarian diet.

Jose lives a sedentary lifestyle and has SOB when walking a flight of stairs. I recommend Jose to take 15-minute walks per day for 3 days a week. Jose can try this plan for 2 weeks. After 2 weeks, Jose can progress form 15 minutes to 30 minutes a day. Since Jose has bilateral knee arthritis, he can try using knee braces/sleeves to provider more stability for his joints. Jose can also try pressure relieving insoles to relieve pressure off his joints. Leisure biking is also recommended for Jose as it is low impact for the knees and can strengthen muscles supporting the knees.