Catherine decided to see a registered dietitian after watching a news story about the 2006 CDC Preconception Health Initiative (p. 66), including the recommendation that each person should make a reproductive life plan. Currently 29 years old, she has been on oral contraceptives for 10 years. She would like to have children someday, possibly in her mid-thirties, after she has established her career. Her height is 5’6" (1.68 m) and her weight is 175 lb. (79 kg). She considers herself fairly active, exercising for about 30 minutes three times per week. Due to being a busy professional, she admits to drinking close to 40 ounces of coffee most days and only occasionally drinks alcohol. Her personal health history includes iron-deficiency anemia at age 25, although she thinks this has resolved; her family history includes heart disease and type two diabetes; both of her parents are still living. No recent lab work is available. Comment on the following questions and number your responses:
Should she change her method of contraception for nutrition or other health reasons?
Are there any risk factors for impaired fertility in her current health status?
What recommendations do you have to help her meet her long-term goal of having children someday?