Question

Mandy is a 10-year-old female with cystic fibrosis who weighs 62 pounds and is 51 inches tall and is considered low active.

1-Calculate Mandy’s estimated energy requirement given her DRI and medical condition using the following information (5 points) 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 if PAL is estimated to be ≥ 1.0 < 1.4 (sedentary) PA = 1.13 if PAL is estimated to be ≥ 1.4 < 1.6 (low active) PA = 1.26 if PAL is estimated to be ≥ 1.6 < 1.9 (active) PA = 1.42 if PAL is estimated to be ≥ 1.9 < 2.5 (very active)

2-Calculate Mandy’s protein requirement given her DRI and medical condition (5 points). EER DRI Table

3-The estimated calorie requirement for an individual with cystic fibrosis is two to four times the usual recommendation. How would one know the appropriate calorie level to recommend initially? (5 points)

4-Research nutrition recommendations for cystic fibrosis that can assist an individual with meeting her high calorie and protein requirements (i.e., use the text and reputable websites). What advice could you provide to a patient?

Answer 1

#. Mandy is a 10year old girl

Her wight is 62lbs ( 62× 0.45kg = 27.9kg) and height is 51inches ( 1.29m) and she is low active ( PA - 1.5)

EER = 135.3 - (30.8 x age [y]) + PA x { (10.0 x weight [kg]) + (934 x height [m]) } + 25

= 135.3- ( 30.8× 10year ) + 1.5× {( 10× 27.9) + ( 934× 1.29m) }+ 25

= 135.3- (308)+ 1.5×( 279)+ (1205)+ 25

= 135.3-(308) + 1468.5

= 1295.8~ 1296kcal

#. Her protein requirement :-

= 0.8gm /kg

= 0.8× 27.9kg = 22.3gm of protein per day .

#. The appropriate calorie level can be calculated by the patient's anthropometric measurement and age .

#. Nutrition recommendation for cystic fibrosis :-

Balanced: dairy, fruits and vegetables, protein with emphasis on high calorie foods

High calorie foods

Whole milk dairy products: whole milk at every meal, cream on cereal, margarine and butter on everything, extra cheese; Peanut butter, ice cream, yogurt, salad dressing, powdered milk

Vitamin supplements

Crucial because of malabsorption; especially fat soluble vitamin supplements = ADEK

Enzymes

enzyme supplements are based on weight, amount of food, bowel movements, growth, and weight gain; take as prescribed

Salt

Add salt to CF children's food; have salty snacks; Increase fluids

Tube feedings

Tube feedings may be necessary for some CF children to assist in gaining weight

Education

Proper administration of enzymes, importance of high calorie meals