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Nutr 453 Spring 2016

Body Weight, BMI, TDE Homework
16 points
TO RECEIVE CREDIT YOU MUST SHOW ALL OF YOUR CALCULATIONS!
Mr. Sparrows wife (Mrs. Sparrow) has decided to come see you. She is a 40 y/o African American
female who is 56 tall with a small frame who weighed 250 lb 3 months ago. She was recently ill and
feels her poor lifestyle and eating habits are to blame. You learn that she lost 25 pounds unintentionally
during the past 3 months due to illness. She is healthy now and does not want to gain back the weight
she has lost. You measure her waist and find that it is currently 40.
Obesity Assessment:
1. a. What is Mrs. Sparrows current BMI?
250 lb 25 lb=225 lb; 56
BMI=wt(kg)/ht(m)2
Wt in kg: 225lb*0.45kg/lb=101.25 kg
Ht in m: 66in*0.035m/in=1.65m
1.652=2.7225
BMI=101.25/2.7225=37.1937.2
a What is her weight classification based upon her BMI?
A BMI of 37.2 falls under the class II obesity category (35.0-39.9)
a. What health risks are associated this weight category according to the 2013
AHA/ACC/TOS guideline?
According to the 2013 AHA/ACC/TOS guidelines the health risks associated with class II
obesity are an increased risk of CVD and all cause morality.
b. What is advised for someone classified this way according to the 2013 AHA/ACC/TOS
guideline?
According to the AHA/ACC/TOS guidelines, it is advised that a person with class II obesity
lose weight.
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a. What is the AHA/ACC/TOS cut-point for abdominal obesity?

The AHA/ACC/TOS cut-point for abdominal obesity is > 102cm (40in) for men and >88cm
(35in) for women.
a Would Mrs. Sparrow be classified as having abdominal obesity according to the 2013
guideline?
Mrs. Sparrow would be classified as having abdominal obesity according to the 2013
guidelines because her waist circumference is 102 cm (40in), which is greater than the cut
point of 35in for women.

a. How much should she weigh according to the Miller equation? You must show your
calculations to get credit using the formula provided in the lecture notes.
Miller Equation: 119# for first 5, 3# for each additional inch
56 small frame
119+(3*6)=137lb
137-(0.1*137)=123.3123
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a Now go to calculator.net and compare your answer to the answers they provide for the
Robinson, Miller, Devine, or Hamwi formulas. How does your calculated value using the
Miller equation compare to the value you got using calculator.net for Miller body
weight? BE SURE TO ADJUST FOR FRAME SIZE FOR YOUR CALCULATED
VALUE AS WELL AS FOR THE VALUES PROVIDED BY CALCULATOR.NET.
Robinson: 49kg+1.7kg per in over 5
130.5-(0.1*130.5)=117.45118
Miller: 53.1kg +1.36kg per in over 5
135.1-(0.1*135.1)=121.59122
Comparison: The Miller formula that I calculated was about 1 lb less than the
Miller value I calculated from calculator.net
Devine: 45.5kg +2.3kg per in over 5
130.7-(0.1*130.7)117.63118
Hamwi: 45.5kg+2.2kg per in over 5
129.4-(0.1*129.4)=116.46117
a. Which IBW is the highest for the following equations: Robinson, Miller, Devine, or
Hamwi? Which is the lowest? Are they all within the range provided by the healthy BMI
recommendation after adjusting for frame size?
114.6-(0.1*114.6)=103.14103
154.9-(0.1*154.9)=139.41139
The health BMI recommendation after adjusting for frame size is 103-139.
All the values calculated fall within this range.
Malnutrition Assessment:
4. As mentioned above, Mrs. Sparrow was recently ill and lost 25 pounds over the last 3
months. Prior to that her weight had been fairly stable for a year. Mrs. Sparrow currently
weighs what % of her usual weight?
(Current wt/formal or usual wt)*100
(225/250)*100=90%
Mrs. Sparrow currently weighs 90% of her usual weight.
5. What % of her usual weight did Mrs. Sparrow lose in the past 3 months?
(amount + or -/former or usual wt)*100= % of usual weight + or
(25/250)*100=10%
In the past three months Mrs. Sparrows lost 10% of her usual weight.
6. Since her weight loss was unintentional how would this amount of weight loss be
classified? Why (be sure to cite your source for your classification and reason)?
Mrs. Sparrows unintentional 10% weight loss over a three month time period was a result of
an illness, poor life style and eating habits. Therefore, this weight loss could be classified as
severe malnutrition as a result of a weight loss greater than 7.5% in 3 months.
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*From White, JV et al. J Acad Nutr Diet. 2012;112:730-738. Consensus Statement of the
Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral
Nutrition:Characteristics Recommended for the Identification and Documentation of Adult
Malnutrition (Undernutrition)
Calculating Energy Needs:
Mrs. Sparrow currently works as a law enforcement officer on rotating shifts; therefore she does
not get much exercise on a regular basis.
7. Calculate Mrs. Sparrows current TDE using the Mifflin St.-Jeor equation and her current
body weight. Round your final answer to the nearest 50 kcal.
Mifflin St.-Jeor equation: [9.99*wt(kg)] + [6.25*ht(cm)]-[4.92*age]-161
Wt in kg: 225lb*0.45kg/lb=101.25kg
Ht in cm: 66in*2.5cm/in=165cm
[9.99*101.25kg]+[6.25*165]-[4.92*40]-161=1684.91685 kcal
AF=1.3 (does not exercise regularly)
IF=1 (no injury)
TDE=REE*AF*IF
1685*1.3=2702.72190.52200 kcal
Mrs. Sparrow is hospitalized about a week later after being in an automobile accident and
suffering skeletal trauma as a result. She is currently bed-ridden and will be for the next month.
As a result, she will not be able to return to work during that time. You have been called to consult
on the case.
8. What is Mrs. Sparrows TDE now? (Round your final answer to the nearest 50 kcal)
TDE=REE*AF*IF
REE=1685 kcal
AF=1.2 (confined to bed)
IF=1.35 (skeletal trauma)
1685*1.2*1.35=2729.72750 kcal
9. If Mrs. Sparrow continues to eat the same amount of energy that she did before her accident
a. How much weight would she be expected to gain or lose during the 30-day recovery
period?
TDE prior to injury TDE after injury=kcal difference/day
(kcal diff/day)*# days=total kcal difference during recovery period
Total kcal diff/kcal per pound= # lbs + or
Will be bedridden for the next month (~30 days)
2200-2750= -550 (deficit)/day
-550*30= -16,500 kcal (lost) in 30 days
-16,500 kcal/3500 kcal per lb= -4.7 lbs lost in 30 days
[4.7/225 (wt prior to injury)]*100= 2.1% loss in 30 days
If Mrs. Sparrows continues to eat the same amount of energy that she did before the accident
she will lose 4.7 lb (2.1%) during the 30-day recovery period.
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b. Should you be concerned? Why or why not? Be sure to cite your sources!
Mrs. Sparrows potential to lose 4.7 lbs in a month (2.1% change) is of concern. It is also of
concern that he lost 10% in the previous three months and now lost about 12% in the past
four months. It is very important that Mrs. Sparrows consumes the amount of calories as
projected by her TDE prior to injury, in order to prevent weight loss and speed a healthy
recovery.
*From White, JV et al. J Acad Nutr Diet. 2012;112:730-738. Consensus Statement of the
Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral
Nutrition:Characteristics Recommended for the Identification and Documentation of Adult
Malnutrition (Undernutrition)