Management of Overweight and Obese Children
The AMA Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity released updated recommendations for the management of overweight and obese children on June 8, 2007. This was co-funded in collaboration with the HHS Health Resources and Services Administration and the CDC. The recommendations are available at: http://www.ama-assn.org/ama1/pub/upload/mm/433/ped_obesity_recs.pdf (you will need these guidelines to complete this case study and the growth charts see http://cdc.gov/growthcharts/).
Stephanie, five years old, has been referred to a registered dietitian because her pediatrician is concerned about her weight gain. Currently she is 54# and 46”.
Questions:
- What is Stephanie’s current BMI and BMI-for-age percentile? How is her weight classified with these new recommendations?
- What areas should the registered dietitian focus on during the dietary assessment according to these recommendations?
- At a three-month follow-up appointment Stephanie is 60# and 46.5”. What is Stephanie’s current BMI and BMI-for-age percentile? How is her weight classified with these new recommendations
- What treatment changes are recommended at this point?
Worksheet 12-2: Calculate Energy and Protein Needs for Children and Preadolescents
Directions:
Use the information on page 277 (Energy Needs), page 317 (Energy Needs), and page 317 (Protein) and the formulas in the table below to answer the questions.
Table: DRIs for Energy for Children (Available at: http://books.nap.edu/openbook.php?record_id=10490&page=107)
EER for Boys 3 Through 8 years
EER = 88.5 − (61.9 × age [y]) + PA × (26.7 × weight [kg] + 903 × height [m]) + 20 kcal
EER for Girls 3 Through 8 Years
EER = 135.3 − (30.8 × age [y]) + PA × (10.0 × weight [kg] + 934 × height [m]) + 20 kcal
EER for Boys 9 Through 18 Years
EER = 88.5 – (61.9 × age [y]) + PA × (26.7 × weight [kg] + 903 × height [m]) + 25 kcal
EER for Girls 9 Through 18 Years
EER = 135.3 – (30.8 × age [y]) + PA × (10.0 × weight [kg] + 934 × height [m]) + 25 kcal
PA = 1.00 (sedentary)*
PA = 1.13 (low active)
PA = 1.26 (active)
PA = 1.42 (very active)
- Calculate the energy and protein requirements for a 4.5-year-old male who weighs 38 pounds and is 39 inches tall and is considered sedentary.
- Calculate the energy and protein requirements for a 5-year-old female who weighs 42 pounds and is 44 inches tall and is considered active.
- Calculate the energy and protein requirements for a 10-year-old female who weighs 85 pounds, is 56 inches tall and is considered low active.
- Calculate the energy and protein requirements for an 11-year-old male who weighs 112 pounds, is 60 inches tall and is considered active.
- What differences do you notice between the children’s energy requirements and the preadolescents’ requirements (i.e. kcal/kg)? Why is this the case?
