Logan is an 8-year-old male coming for outpatient nutrition counseling after diagnosis with Prader Willi syndrome and referral from his pediatrician. Logan was referred due to recent dramatic increase in weight over the past 3 months, now above the 99th percentile on the CDC growth charts. His parents report that Logan is constantly asking for food and snacking throughout the day, and he has started sneaking food into his room at night.
Anthropometric Data:
Biochemical Data:
HbA1c 6.5 (4.3%-5.8%)
Clinical Data:
Past Medical History: None Medications: Somatotropin Vital Signs: Blood pressure: 130/68 mm Hg Nutrition-focused Physical Exam: Patient appears obese consistent with android body type. Hair and nails appear normal. Skin is pale, warm, and intact. Exam is limited due to patient’s irritability.
Dietary Data:
24-hour Diet Recall: Breakfast: Bacon, eggs, pancakes, orange juice Snack: Granola bar, milk, fruit Lunch: Sandwich (turkey/cheese), chips, pickles, crackers, cookie, milk Snack: Cheese, crackers, juice Dinner: Mac and cheese, peas, bread and butter, chicken, milk, water Snack: Ice cream, candy
1. How would you describe Logan’s nutritional status?
2. What are his calorie goals?
3. What education might you provide for Logan?
4. Identify an intervention to adress Logan’s nutritional issues.