Question

EJ is a 14-year-old male who currently resides at a behavioral health resident treatment facility. He has been diagnosed with obesity and hyperlipidemia, most likely due to side effects from the medications he is taking for bipolar disorder. The registered dietitian has been asked to speak with EJ about his new diet order for a low-fat diet and to provide suggestions to EJ’s family. EJ is expected to return home next month. His family has been participating in family counseling weekly with EJ while he has been at the facility. Currently EJ is 195 pounds and 70 inches tall. EJ’s mother reports that EJ typically eats at fast-food restaurants after school three or four days a week. His intake of fruits and vegetables has only been 1-2 daily while at the facility, and his mother indicates this is more than he eats at home. When EJ does drink milk, it’s usually whole milk. EJ’s family is very busy, and often EJ and his two older siblings prepare their own dinner.

Questions:

1. What is EJ’s BMI? How does this classify his weight at this time?

2. What dietary recommendations do you have, specific to EJ’s situation, that can help him improve his nutritional intake and reduce his fat consumption?

3. What guidelines do you need to keep in mind as you provide nutrition education and counseling to adolescents?

4. Research the impact of family meals in the lives of adolescents using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/). What is the consensus on family meals as they relate to the health of adolescents?

Answer 1

1. The calculation of body mass formula is kg/m²

weight of EJ = 195 pound=88.45 kg

Height of EJ =70 inch = 1.7 m

BMI= 88.45/ 1.7*1.7

EJ BMI is =30.60

BMI Interpretation

Below 18.5 = under weight

18.5 to 24.99 = Normal

25 to 29.99 = over weight

30 and above = obese

EJ falls under criteria of obese

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2.Dietary recommendations to EJ's situation

Foods to add

a) A variety of whole grains sucha as bran and oats

b) Fishses such as salmon, mackerel and tuna

c) foods rich in antioxident such as fruits and vegetables

d) Foods high in omega fatty acids such as avacado, flax seeds, olive oil and canola oil

e) foods rich in plant steroids such as Walnuts and almonds

Foods to aviod

a)Animal produscts high in saturated fats such as ( Beef, Lamp,pork, duck,cream. cheese butter and egg yolk)

b) Fried foods

c) High fat processed meals such as hot dogs and sausages

d) simple sugars found in sofy drinks, candies,cookies and baked goods

e) Saturated oil such as coconut oil and palm oil

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3.Guideline to keep in mind before counselling adolescents regarding nutrition

a) Replacing negative thoughts to positive

b) Repeating information through questions

c) Deep listening

d) Skillful questions ( open ended and closed ended)

e) Goal setting