Current research indicates that the cause of obesity is multifactorial. Briefly outline the roles of genetics, environment, and nutritional intake in development of obesity in children.
- The Problem
Background Story: Margaret was taken to her doctor because of her breathing problem when sleeping. Her doctor diagnosed her with sleep apnea related to her weight and referred to the registered dietitian for nutrition counselling.
Personal Information:
Name: Hufalar, Margaret G.
Gender: Female
Height: 5’4"
Weight: 175 lbs
Doctor’s Diagnosis: Obstructive sleep apnea (OSA) secondary to obesity and physical inactivity
Nutrition:
General: Very good appetite with consumption of a wide variety of foods. Margaret’s physical activity level is generally low. She discontinued physical activities for five years now. She likes playing video games and reading.
Sample of 24-hour meal recall:
Breakfast: 4 servings of pancakes (4 inches across, 1/4 inch thick), 8 oz whole milk, 4 oz apple juice
Lunch: 2 burrito and cheese sandwiches (2 slices of white bread, 1 oz. mozzarella, 1 tbsp mayonnaise each) 1-oz pkg potato chips, 8 oz whole milk
After school snack: Peanut butter and jelly sandwich (2 slices white bread with 2 tbsp crunchy peanut butter and 2 tbsp fruit jelly), 12 oz wholemilk
Dinner: Skinless lean chicken (10 oz.), 1 c mashed potatoes, 1 c blanched okra, 16 oz lemonade
Snack: 3 c microwave popcorn, 12 oz Coca-Cola
Vitamin intake: Multivitamins (plus zinc) daily
- Laboratory Results:
|
Chemistry |
Reference Range |
Physical Assessment Results |
|
Sodium (mmol/L) |
136-145 |
142 |
|
Potassium (mmol/L) |
3.5-5.5 |
4.3 |
|
Chloride (mmol/L) |
95-105 |
101 |
|
Creatinine (mg/dL) |
0.6-1.2 |
0.6 |
|
Glucose (mg/dL) |
70-110 |
122 ↑ |
|
Bilirubin total (mg/dL) |
≤1.5 |
0.1 |
|
Protein, total (g/dL) |
6-8 |
6.2 |
|
ALT (U/L) |
4-36 |
5 |
|
AST (U/L) |
0-35 |
6 |
|
Cholesterol (mg/dL) |
<170 |
180 ↑ |
|
HDL-C (mg/dL) |
>55 F, >45 M |
34 ↓ |
|
LDL (mg/dL) |
<110 |
125 ↑ |
|
LDL/HDL ratio |
<3.22 F; <3.55 M |
3.68 ↑ |
|
Triglycerides (mg/dL) |
≤150 |
114 |
1. Current research indicates that the cause of obesity is multifactorial. Briefly outline the roles of genetics, environment, and nutritional intake in development of obesity in children.
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