Calculate and plot Brian’s BMI over time. What do you see? (Appendix 7, p. 943)
ID: 82568 • Letter: C
Question
Calculate and plot Brian’s BMI over time. What do you see? (Appendix 7, p. 943)
What recommendations can you make to prevent Brian and his mother from resuming old habits?
You would like to instruct Brian and his mother on the “Division of Responsibility” for a positive feeding relationship, what is this?
Discuss suggested portion sizes for Brian for the different food groups
What can you suggest to help Brian avoid or reduce the tendency to eat when he is not hungry?
What are recommendations for fish intake for younger children?
What if Brian develops a food jag?
What are recommendations for weight loss for Brian considering his age?
What are Brian’s energy and protein requirements for his current weight?
Considering Brian’s age and cognitive development, what can you do to educate Brian on his food choices and nutrition?
CLINICAL CASE STUDY Brian is a 7-year, 4-month-old male who gained 15 pounds during the past school year. His height is 50 inches, and his weight is 75 pounds. Brian moved to a new home and began a new school a year ago atter his parents divorce. Atter-school care has been pro- vided by a retired neighbor, who loves to bake for Brian. He has few friends in the neighborhood, and his main leisure activities have been watching television and playing video games. When he gets bored, he otten looks for a snack. His mother reports that they otten rely on take-out and fast-tood meals because the time constraints her full-time job, and she has gained weight herselt. She recently started an aerobics class with a friend and is interested in developing healthier eating habits tor herselt and Brian Atter joint sessions with Brian and his mother, the tollowing goals were identified by the tam 1) re atter-school care at the local community center, which has a physical activity component; (2) alter grocery and menu selection to emphasize the MyPlate and low-tat choices while still meeting the fami time and resource constraints ly's (3) begin to incorporate physical activities Brian identified swimming and bicycling as things he would like to do) on the weekends; and (4) limit television and video games to no more than 2 hours dail Atter 4 months, Brian has enrolled in the local community center's atterschool program and participates in organized soccer and "pick up" basketball. Weekends are a challenge. Brian and his mother have not yet incorporated physical activity into their weekend routine, and an finds it tough to mit screen time to 2 ho s on the weekends. an has lost 4 pounds and is ta s 51 inches tal and weighs 66 pounds Nutrition Diagnostic Statement Overweight/obesity as evidenced by BMI-tor-age above the 95th per centile or more related to infrequent physical inactivity, large amounts of sedentary activity, and estimated excessive energy inta Nutrition Care Questions 1. Calculate and plot Brian's BMI over time. Discuss the changes 2. What recommendations should be made to prevent Brian and his mother from resuming their old habits? 3. What other activities can Brian try to help him avoid or reduce the tendency to eat when he is not hungry? hat would you suggest to promote a positive teeding relation ship between Brian and his mother, considering his age and level ot development? 5. What recommendations can you make to decrease Brian's energy in take and make it more consistent with MyPlate recommendations Consider ideas to alter Brian's favorite recipes (e.g., his tavorite meal is tried chicken with gravy, mashed potatoes, and ice cream), select healthy options from take-out or fast-tood options, and modifications to snack options 6. Are there any nutrient-related concerns because Brian's diet is being altered to help with weight management? Or because of his age? Or other actorsExplanation / Answer
Answer 1. BMI formula for kids = (weight / (height x height)) x 703
At age of 7 years 4 months, His BMI = 75/(50.5 x 50.5) x 703
= 20.67
At age of 7 years 8 months, His BMI = 66/(51 x 51) x 703
= 17.83
there is an improvement in Brian BMI in last 4 month due to her mother efforts of change in her and her son's lifestyle.
Answer 2. Brian and his mother should stick to their new routine and lifestyle and should try to improve it.
Her mother should be discussed the changes that brain has got after the lifestyle change so that brian can be grateful to that and get motivated to improve his lifestyle and try not to return to his old lifestyle.
They both should try to indulge in more activities and homemade food on weekends as they get more time on weekends than weekdays. Brian should be encouraged to play outdoor games with his friends or his mother to cut screen time.
Answer 3. Brian and his mother should develop Division of Responsibility for a positive feeding relationship.
Answer 4. Suggested portion sizes for Brian(7-12years age group) for the different food groups
Grain products - Brown bread slice 1, half cup Rice, Pasta, or Potatoes. Ready to eat cereal 1 cup.
Fruits and veggies - cooked vegetable half cup, pureed vegetable half cup and one cup raw vegetables as the salad.
2 Different type of fruits raw daily and 5-7 ounces of fresh fruit juices.
Dairy Products - 1-2 ounces cheese and one cup milk/curd/yogurt.
Other Products - 2 eggs, 2 tablespoon peanut butter, 2 ounces meat/poultry/fish, 1 cup beans.
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