Question

Liam is a 17-year-old male who is being seen by his family physician for his annual physical examination. Liam’s sexual maturation rating is estimated to be 3. He weighs 114 lbs and stands 5’6” tall.

When he was 16 y.o., his height was 5’5” and weight was 106 lbs.
At 15 y.o., Liam was 5’3” tall and weighed 98lbs.

During the visit, Liam reports that he has been experimenting with a vegan diet since his visit last year. He explains that he thinks it is a healthier way to eat and states that he avoids milk, beef, and pork eats poultry or fish once every two weeks and eats cheese 3-4x/wk. Breakfast is usually cold cereal with almond milk because he heard that was a healthy milk alternative. He likes pasta, pizza, and salad, which he eats almost every day.
For exercise, he runs 3 miles 2x/wk, plays basketball with friends after school 3x/wk for an hour, and lifts weights in his garage for 45 min 5x/wk.
He says he would like to gain muscle and grow taller.

1. Plot Liam’s weight for age, height for age, and BMI for age for the two years given. What percentiles for each does he fall in? Starting from 15 until now, interpret Liam’s height, weight, and BMI changes over time?

2. With an activity factor description of “very active”, estimate Liam’s energy needs.

3. What clarifying questions would you like to ask Liam about his current behaviors? List 3.

4. If there is protein a concern in Liam’s diet, why? Estimate his RDA and use evidence to support your position.

5. Given Liam’s diet and exercise patterns, which dietary components may he be deficient in? For each dietary component, list possible food sources that are appropriate for his current eating pattern.

6. There are both health benefits and costs to eating mostly plants. How might his current way of eating affect Liam’s growth and maturation?

7. Is it necessary to assess Liam for the presence of an eating disorder? Provide support for your answer.

Answer 1

1. At the age of 16 years old

Weight = 106lbs (61 kg)

Height = 5'5" ( 165cm)

BMI = m(mass in kg)/ h2 (height in meters)

= 61/ (1.65 ×1.65)

= 17.6 ( underweight)

At the age of 15 years old

Weight = 98 lbs ( 57kg)

Height = 5'3" ( 160cm)

BMI = m/h

= 57/ ( 1.6×1.6)

= 17.4 ( underweight)

At 16 years old he fall in the BMI- for- age at the 9th percentile for boys at age16 years . This child has healthy weight.

At 15 yesrs old he fall in the BMI - for - age at the 12th percentile for boys at age of 15 years . This child has healthy weight.

At 17 years

Weight = 114 lbs ( 64kg)

Height = 5'6" ( 168cm )

BMI = 64/ (1.68 × 1.68 )

= 18.4

When comparing the height , weight and BMI from the age 15 to 17 , Liam improving on his health. He is maintaining normal body weight and heght according to his age and maintaing normal health status.

2. Estimated energy needs

Step 1 Calculate Basic Metabolic Rate

BMR = 66+(6.23×weight in pounds ) + ( 12.7 × height in inches ) _ ( 6.8 × age in years)

BMR = 66+(6.23×114) + ( 12.7 × 66.141)_(6.8×17)

=1500.61calories perday.

Step 2 calculate energy expended for physical activity

EEPA= BMR × ACTIVITY LEVEL

= 1500.61× 1.725 ( very active level)

= 2588.55

Step 3 calculate specific dynamic action of food by multiplying step 2 by 10%

2588.5× 0.1= 258

Step 4

Add the total from the step two to the total from step 3 to get the overall number of calory

2588+ 258=2846 calories