FN-417/617 Fall 2017

Wendy Barth
FN-417
September 19, 2017

Introductory NCP Case Study

Due by September 19th at 10am in the Dropbox

1. What is AR’s BMI? What is his BMI classification (Normal? Overweight? Obese?)
BMI: wt in kg/ht in meters2
220#: 99.79 kg
5’11”: 71 in., 180 cm 99.79 kg/1.80 m2 = 29.78kg/m2

Classification: Overweight

2. If you classified AR as overweight or obese, would you use his current/actual weight or what he states is his
usual weight to calculate his energy needs? Or would you use another weight to calculate his energy needs?
Explain your answer.
I classified AR as overweight I would use his current/actual weight to calculate his energy needs. I
would do this because it is the most accurate to go off of since it is his most current data.

Use adjusted wt if BMI is over 30

(Current wt - ideal body wt) x .25

220-160 x .25 = 15#

160+15=175#

3. Using the Mifflin-St. Jeor equation, what would you estimate as his daily energy demands?
Mifflin-St. Jeor equation for males: REE(kcal)= (10 x w) + (6.25 x h) – (5 x a) + 5
(a= age, w= weight in kg, h= height in cm)

(10 x 99.79kg) + (6.25 x 180.34cm) – (5 x 52 yr old) + 5 = 1870.025 kcal ~1870 kcal

Activity: 1.3 ambulatory, low activity

1870 x 1.3 = 2,431 kcal/day

4. What activity factor did you use, and why?

I used the activity factor of 1.3 because AR is very inactive and spends most of his time at work, at
his desk. 1.3 is one of the lowest factors that can be used without having him be bed bound;
ambulatory, low activity but not sedentary.

5. Now calculate AR’s energy needs using the appropriate kcal/kg body weight?
99.97 kg x 20-25 kcals/bw = 1999.4 - 2499.25 ~ 2000 – 2500 kcal/day

Harris Benedict equation for males: REE=66.5 + (13.8 x w) + (5.0 x h) - (6.8 x a)

66.5 + (13.8 x 99.79) + (5.0 x 180.34) - (6.8 x 52) = 1991.7 kcals

1992 x 1.3 = 2590 kcals/day

6. Do the two energy equations differ in recommended amount of kcals? Which one would you use?
FN-417/617 Fall 2017
Between the two energy equations, they differ in the recommended amount of kcals needed
for an individual. Since AR is overweight, I would use the Mifflin St. Jeor equation. In this
particular case, both equations give a similar amount of kcals per day so either one will do.

7. Summarize your nutrition assessment, based on the 5 domains of nutrition assessment data (Nutrition
History, Biochemical Data, Anthropometric Data/Measurements, nutrition focused Physical Findings, and
Client History) using terminology (in the IDNT Reference Manual).

Food /Nutrition History-

Client does not eat breakfast at home, usually taking several cookies or a large muffin to go. Home
meals are prepared in a traditional Brazilian fashion being deep fried in lard. The meals also include
potatoes, meats, fruits, vegetables, and gravies. Lunches at work are often eaten in the cafeteria and include
large portions of meats and other favorites. Away from home meals include “all you can eat” buffets. Client
drinks several cups of coffee every day, with cream and sugar, and at least one sweetened soda. Frequent
snacking is also normal for the client since snack food is always on hand at home and work. Client is
knowledgeable on cooking and preparing meals but says he doesn’t have the time. Client also does not get
regular physical activity but has a desire to lose weight and change eating habits.

Anthropometric Data/Measurement-
Ht: 72”, Wt: 220#, BMI: 29.78 kg/m2 (overweight), weight gain of 30# in 4 years

Biochemical Data-
Not provided.

Nutrition focused Physical Findings-

Increased adiposity

Client History-
Client is a 52-year-old male, married with children. AR has a Brazilian background and prepares
meals accordingly. Client grew up in a restaurant setting where he learned to cook and continues to
use these skills in his adult years. AR has a family history of diabetes and expresses concern about
developing diabetes in the future. The client works full time as a school principle.

8. Write at least one (1) PES statement to identify a nutrition diagnosis for this case. Use the Nutrition
Diagnostic Reference Sheets (in the IDNT Reference Manual) to help formulate your PES statement
Excessive energy intake r/t a3700 kcal/day diets and inadequate exercise, AEB a 29.78 BMI, daily
intake of 90g saturated fat, and a daily intake of 25% kcals from sugar.

9. A Nutrition Prescription
Decrease calorie intake by 600 kcal/day, increase physical activity to a minimum of 30 min/day,
and increase consumption of fruit and vegetable servings

10. Nutrition goals/expected outcomes for AR. Be sure to use the language for nutrition intervention, based
on the appropriate intervention domains and classes
RDN educated patient on portion sizes and healthier fast food choices.
RDN educated patient on behavioral changes involving meal planning and preparation.
RDN educated patient on increasing daily physical activity.

11. Include strategies that you would suggest to achieve each of the goals/expected outcomes that you have
identified in #10 for AR.
Limit restaurant/fast food visits to 1-2 times per week.
Portion and prepare healthy meal choices with family members 2-3 times per week.
FN-417/617 Fall 2017
Incorporate exercise into lunch periods or after work, 2-3 times per week.