From the information in chapter 16, what are some factors that may have contributed to Jossy’s excess weight gain over the past year?

1. Jossy is 6 year old and is in elementary school. At her last doctor visit, her measured height was 46 inches and her weight was 60 pounds. Her pediatrician voiced concern over Jossy’s excessive weight gain over the past year. Her usual diet consists of sweetened cereal with whole milk and fruit juice for breakfast and a juice drink and crackers for her mid-morning snack. On school days, Jossy buys her lunch at school; her favorite menu items are pizza and tacos. Jossy’s mother states that she started a new job this past year, which requires that Jossy attend an after-school program until 6 in the evening. She receives a snack there, usually an 8 oz box of fruit juice and crackers. Jossy’s parents report that Jossy is “always hungry” and they will often stop for her favorite chicken nuggets, fries, and soda on late evenings when the family is too tired to cook. Jossy likes to play video games and has a computer and television in her room. Her father complains that she spends more time in her room than playing outside. Jossy’s mother is overweight and her father is of normal weight, although he states he was overweight as a child. The family has discussed getting more exercise on the weekends but are not sure how to add this to their already busy schedules.

a. Calculate Jossy’s body mass index (BMI) and use this to evaluate her weight status using the information in Figure 16-10.

b. From the information in chapter 16, what are some factors that may have contributed to Jossy’s excess weight gain over the past year?

c. Considering her age and the information in chapter 16, what would be a reasonable weight management goal for Jossy?

d. Using the recommendations in Table 16-7, what strategies would you suggest that Jossy and her parents incorporate into their current lifestyle?

e. Based on her usual intake, identify at least 2 or 3 nutrients likely to be deficient in Jossy’s diet. What major food groups provide these nutrients?

f. Assuming her current level of activity, what are Jossy’s estimated daily kcalorie needs according to Table 16-5?

2. Chablis is a 14 year-old female who has been referred to you by her mother and family physician. Mom is concerned that Chablis is not eating right and her doctor wants you to give Chablis some nutrition advice because she wants to be a vegetarian. Chablis has heard that red meat contains a lot of fat and she “does not want to get fat.” A physical exam by her physician shows that Chablis is in the early stage of sexual maturation, she weighs 89 pounds, and she is 5 feet tall. Chablis is extremely active, spending every afternoon after school playing some kind of sport – basketball, swimming, track, or soccer.