Sally Case Study- Age: 12 yr old, 5.5 mo Female. Anna reports no medical concern

Question

Sally Case Study- Age: 12 yr old, 5.5 mo Female. Anna reports no medical concern. Mother reports concern over recent weight gain.

Lab results show:

Sexual Maturity Rating (SMR): early stage 3                       

BMI: 23.3

Menarche: Not occurred yet

Hematocrit: 35.1%

Height: 58 inches

Hemoglobin: 11.9 g/dl

Weight: 111 lbs.

Blood Pressure: 121/77

Sally reports no medical concern. Mother reports concern over recent weight gain.

Sally’s last hospital visit was 5 months before for an upper respiratory infection.

Lab results 5 months before: BMI: 21.4; Previous height: 56 inches; Previous weight: 95 lbs.

Sally is referred to a nutritionist for counseling and weight management, where a 24 hr. dietary recall is suggested.

24 hour recall results show:

Breakfast:

7 am- 8 oz. apple juice at home

10 am- candy bar from school vending machine

Lunch:

12:15 pm- Hamburger from school cafeteria, non-diet cola, and 1 oz. bag of potato chips

3 pm- 3 oz. tortilla chips with ½ cup cheese sauce and 12 oz. non-diet cola at home.

Dinner:

6:30 pm- 2 c. chicken casserole, 8 oz apple juice, 2 crescent rolls with 1 TB butter

8:30 pm- 8 cups of butter flavored microwave popcorn

Physical activity: Walked in between classes 1-2 minutes. Played basketball for 35 min. Walked 3 blocks. Sat in classroom for 35-45 minutes. On computer for 40 minutes. Watched television for 2 hours.

Questions:

1. Given her current weight classification (based on BMI), what are the current recommendations for weight management? (Reference what you used for a source)

2. What do the SMR and the absence of menarche tell you about Anna’s potential for linear growth and future weight gain?

Sexual Maturity Rating (SMR): early stage 3                       

BMI: 23.3

Menarche: Not occurred yet

Hematocrit: 35.1%

Height: 58 inches

Hemoglobin: 11.9 g/dl

Weight: 111 lbs.

Blood Pressure: 121/77

Explanation / Answer

1. Ans:

Anny has increased her weight from 95lbs to 111lbs

Calculate BMI based on given details (12yrs, 50.3pounds, 4.8feet) = 11.28kg/m2.(Underweight)

The BMI value given is wrong 23.3, it is not overwight, she is underweight,

She is required to take high protein rich diet. not required to do diet management as she is increasing height she needs to gain weight as well.

2. Ans.

SMR 3 development at 12yrs of age is ok, It tells us that when she reaches SMR 4stage she is going to fall in menarche stage (menstrual cycle starts)

At this age we should ask anna eat lot of protein and fat to develop her personality with the good health, at this if sh cant manitain her diet whe will never build up her personality with proper weight which further leads to hormonal imbalance and related health problems.

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