Samuel is a 63-year-old single man who works full time in a food processing plant. He has a history of alcohol abuse and esophag
eal cancer, which was treated successfully with anti-cancer drugs and surgery four years ago. His weight had been stable at 135 pounds until the past 6 months, in which he has experienced an involuntary weight loss of 10 pounds. He is 67 inches tall and his current BMI is 19.5. He complains of a poor appetite and being overly weak and tired. He also complains of cracks at the corners of his mount and a chronic sore throat which concerns him, given his cancer history. His usual diet is fairly consistent. He states that he rarely eats breakfast because he starts work at 6 a.m. He eats two deli meat sandwiches, "usually pastrami or salami," and a soda at 10 a.m., and may eat a candy bar in the afternoon when he gets off work. He often prepares frozen dinners or pizza at home in the evening and routinely drinks "about 4 or 5 beers" before going to bed. Occasionally he will cook a roast and mashed potatoes. He occasionally will have milk with cereal but rarely eats vegetables or fruit. He would like to know which vitamin supplement will give him energy. Would you recommend that Samuel take a vitamin and mineral supplement? Why or why not?
I would recommend that Samuel takes Vitamin C and D but not necesarily from a supplement. He needs a nutritional diet nonetheless and needs to cut excess sodium out of his diet. I would have him return bimonthly for workups.
