Medical Nutrition Therapy: A Case-Study Approach , 5th Edition Solution Manual

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Answer Guide forMedical Nutrition Therapy: A Case Study Approach5thed.Case 1–Pediatric Weight ManagementI.Understanding the Disease and Pathophysiology1.Current research indicates that the cause of childhood obesity ismultifactorial. Briefly outline howgenetics,environment, and nutritional intake might contribute to the development of obesity in children.Biological (genetics and pathophysiology):•30%-75% of adiposity in children is related to genetics•In children < 3 years of age, the strongest predictor of adulthood obesity is parental obesity•Both prenatal undernutrition and overnutrition appear to increase lifelong risk for obesity•Genetic/hormonal: Some of the most common are:oPrader-Willi syndromeoCushing’s syndromeoHypo-/hyperthyroidismEnvironmental (sedentary behaviors, SES, modernization, culture, dietary intake):•Video and computer games and cable and satellite television have made sedentary activities more appealingo98% of children inthe U.S. live in homes with at least one televisiono80% of children live in homes with at least one DVD playeroHalf of the children who live in the U.S. have at least one video game system in their homesoOn average, children spend 3 hours per daywatching television•African American and Hispanic children participate in fewer vigorous activities and/or more sedentaryactivities than Whites•Girls are less physically active than boys•Dietary factorsoLow intake of vegetables and fruitsoHigh intake of fast foods and sweetsoIncreased consumption of sugar-sweetened soft drinksoSkipping breakfastoIncreased consumption of refined carbohydrates (ready-to-eat cereals, potatoes, cakes, biscuits, softdrinks)oIncreased parental work hours influence (leads to higher consumption of energy-dense foods)oConsumption of all 3 meals leads to 63% lower risk of being overweight/obeseMother smoking during pregnancy; increased risk of being overweightExtensive food marketing towards children (via video games,internet, TV, cell phones, etc.)Global (society, community, organization, interpersonal, individual):•Community design focused on cars has discouraged walking and bike riding•Increased concerns about safety limit timesand areas in which children play outside•Time in physical education classes in schools has decreased•Limited number of parks and recreation areas in communities2.Describe one health consequence for obese children affecting each of the following physiological systems:cardiovascular, orthopedic, pulmonary, gastrointestinal, and endocrine.•OrthopedicoAbnormalities affecting feet, legs, hipsoSlipped capital femoral epiphysisoBlount’s disease (bowing of lower legs & tibial tortion)•NeurologicaloPseudotumor cerebri (increased pressure in skull)oRecurrent headaches•PulmonaryoAsthma

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