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Nutrition 415 Case Study Questions Oct. 28, 2009

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Nutrition 415 Case Study Questions
Oct. 28, 2009
Stephanie Hunley
Kayla Kmet
Lora Lee Aaron
Rebecca Willis
I. Understanding the Disease and Pathophysiology
1. Current research indicates that the cause of childhood obesity is
multifactorial. Briefly discuss how the following factors are thought to play a role
in the development of childhood obesity: biological (genetics and pathology);
behavioral-environmental (sedentary lifestyle, socioeconomic status,
modernization, culture, and dietary intake): and global (society, community,
organizational, interpersonal, and individual).
a. Genetics: a child's genes can be mutated and cause obesity or a child can have a
genetic predisposition to become obese although it probably plays a much smaller role
than environmental factors.
b. Behavioral/ environmental: Children participate in many environments. Typically, the
most influential is the home. Their parents' socioeconomic status dictates the food
available and, if both parents work, how much time can be dedicated to preparing food.
As our world continues to quicken its pace, drive throughs and frozen entrées look
increasingly appealing despite their energy and salt density. TV watching is detrimental
on three counts. First, it is a sedentary activity that can sustain engagement for hours,
taking time away from active play for children to learn, rev up their metabolism, use
calories, build muscle, coordination, strong bones, and cardiovascular fitness. Second,
it encourages snacking, and snacking, and snaking. Whether it is healthy food or
unhealthy, too much is consumed. Thirdly, commercials advertise unhealthy foods to
children as part of our culture's marketing strategy and it works. Children learn to desire
unhealthy foods they see on TV. One reason many children are inside in the first place
is the reality or the perception that it is unsafe for them to be outside. Especially for
children who's parents work full time, going outside is not an option. Even sadder still,
in children's schools, where they it is safe for them to go outside, many gym programs
are being shut down or punishment for misbehavior is tame taken away from time
outside. Also in schools, although children have some less healthy options, the menu's
in schools represent one third of children's nutritional needs. In addition, there are
policies being put into place to limit or forbid the promotion of "junk food" for parties or
for sail.
c. Global/ personal- Globally, larger portion sizes are the trend. Consumers pay more
and get more, but they also eat more just because it is on their plates. We are now at a
place at least in America that we actually believe that the typical portion sizes we
receive at restaurants are what we should actually be eating, which is also know as
portion distortion. Another global trend in the US has been the urban sprawl. Because
our homes, businesses, and grocery stores are too far apart to walk, we drive
everywhere, even if it is across the parking lot, because it is esyer. We, as a society,

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have learned to expect easy access to whatever we need. Further, there is all most no
where we can not drive to. A trend in families is the dinner table's status as the sacred
gathering place of the family. With out that status, less care may be taken regarding the
quality of the food; plus, families loose the interactions needed to teach children how to
make good food choices and why.
2. Describe health consequences associated with an overweight condition.
Describe how these health consequences differ for an overweight versus an
obese condition.
For every five point increase in BMI a person enters a higher bracket of disease risk.
The diseases and conditions do not necessarily increase in number, but the likelihood of
developing the co morbidities, diabetes, gall bladder disease, hypertension,
dyslipidaemia (too much fat in the blood), and sleep apnea, increase. Other health
related consequences that become more severe or more likely as one progresses from
overweight to obese include coronary heart disease, osteoarthritis (deterioration of
cartilage in knees), hyperuricaemia (too much uric acid in the blood) which may result in
gout (swelling in feet from deposited uric acid), cancer, reproductive hormone
abnormalities, polycystic ovarian syndrome, impaired fertility, low back pain, increased
anaesthetic risk (loss of sensation or consciousness), and fetal defects from maternal
obesity.
3. Missy has been diagnosed with obstructive sleep apnea. Define sleep apnea,
Explain the relationship between sleep apnea and obesity.
Periods during sleep when individuals stop breathing. The correlation between obesity
and disordered sleep exists but it is difficult to pin down exactly why. It may be due to an
alteration in the function of the airways. Researchers have found, in some obese
patients, abnormalities in the soft tissue of their upper air way. Sleep apnea is also
positively correlated to hypertension, a co morbidity of obesity. Weight loss appears to
be effective in treating sleep apnea.
II. Understanding the Nutrition Therapy
4. What are the goals for pediatric weight loss in the pediatric population? Under
what circumstances might weight loss in overweight children not be appropriate?
Reducing sedentary activities like TV viewing and increasing physical activity. Focus of
weight maintenance, not loss because children can grow into their weight, and to
reduce their overall calorie intake below quantities for a normal weight child may result
in impaired growth and development. Especially if the child was ill or had undergone
surgery, weight loss should not be recommended for him/her. The goals should
include the family and progress gradually. For Missy and her family specifically, the
family as a whole can pursue a more active lifestyle by taking a walk, going to a park, or
even playing the wii instead of watching television. The other component is diet. They
need to monitor Missy's intake. Especially if she could keep a food diary herself, she
would become more conscious of her eating and less likely to eat out of boredom if she

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 Nutrition 415 Case Study Questions Oct. 28, 2009 Stephanie Hunley Kayla Kmet Lora Lee Aaron Rebecca Willis I. Understanding the Disease and Pathophysiology 1. Current research indicates that the cause of childhood obesity is multifactorial. Briefly discuss how the following factors are thought to play a role in the development of childhood obesity: biological (genetics and pathology); behavioral-environmental (sedentary lifestyle, socioeconomic status, modernization, culture, and dietary intake): and global (society, community, organizational, interpersonal, and individual). a. Genetics: a child's genes can be mutated and cause obesity or a child can have a genetic predisposition to become obese although it probably plays a much smaller role than environmental factors. b. Behavioral/ environmental: Children participate in many environments. Typically, the most influential is the home. Their parents' socioeconomic status dictates the food available and, if both parents work, how much time can be dedicated to preparing food. As our world continues to quicken its pace, drive throughs and frozen entrées look increasingly appealing despite their energy and salt density. TV watching is detrimental on three counts. First, it is a sedentary activity that can sustain engagement for hours, taking time away from active play for children to learn, rev up their metabolism, use calories, build muscle, coordination, strong bones, and cardiovascular fitness. Second, it encourages s ...
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