Sally Case Study- Age: 12 yr old, 5.5 mo Female. Anna reports no medical concern

Question

Sally Case Study- Age: 12 yr old, 5.5 mo Female. Anna reports no medical concern. Mother reports concern over recent weight gain.

Lab results show:

Sexual Maturity Rating (SMR): early stage 3                       

BMI: 23.3

Menarche: Not occurred yet

Hematocrit: 35.1%

Height: 58 inches

Hemoglobin: 11.9 g/dl

Weight: 111 lbs.

Blood Pressure: 121/77

Sally reports no medical concern. Mother reports concern over recent weight gain.

Sally’s last hospital visit was 5 months before for an upper respiratory infection.

Lab results 5 months before: BMI: 21.4; Previous height: 56 inches; Previous weight: 95 lbs.

Sally is referred to a nutritionist for counseling and weight management, where a 24 hr. dietary recall is suggested.

24 hour recall results show:

Breakfast:

7 am- 8 oz. apple juice at home

10 am- candy bar from school vending machine

Lunch:

12:15 pm- Hamburger from school cafeteria, non-diet cola, and 1 oz. bag of potato chips

3 pm- 3 oz. tortilla chips with ½ cup cheese sauce and 12 oz. non-diet cola at home.

Dinner:

6:30 pm- 2 c. chicken casserole, 8 oz apple juice, 2 crescent rolls with 1 TB butter

8:30 pm- 8 cups of butter flavored microwave popcorn

Physical activity: Walked in between classes 1-2 minutes. Played basketball for 35 min. Walked 3 blocks. Sat in classroom for 35-45 minutes. On computer for 40 minutes. Watched television for 2 hours.

Questions:

1. Given her current weight classification (based on BMI), what are the current recommendations for weight management? (Reference what you used for a source)

2. What do the SMR and the absence of menarche tell you about Anna’s potential for linear growth and future weight gain?

Sexual Maturity Rating (SMR): early stage 3                       

BMI: 23.3

Menarche: Not occurred yet

Hematocrit: 35.1%

Height: 58 inches

Hemoglobin: 11.9 g/dl

Weight: 111 lbs.

Blood Pressure: 121/77

Explanation / Answer

1).

). Body mass index (BMI) provides an estimated value of requires body weight for a particular height (weight-for-height).

BMI = Body weight (in kilograms)/ Height2 (in meters)

The BMI value of a “healthy weight for height” ranges in between 18.5 to 24.9. BMI of more than 25 indicates health risks.

Sally's BMI is 23.3, which does not indicate any excess body weight. However, the balanced diet must be considered to avoid any excessive weight gain in the future. Reducing the current calorie intake is not recommended because Saly's height will increase, so the weight must also be increased accordingly.

2). As Menarche has not occurred in Salley, her height increase in future, so there should be weight gain accordingly.

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