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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?
a. (225# / 66in^2) x 705 = 36.4
a What is her weight classification based upon her BMI?
a. She is in the class II obesity. This is classified as BMIs ranging from 35.0-39.9
a. What health risks are associated this weight category according to the 2013 AHA/ACC/TOS
guideline?
a. In class II obesity, she is at increased risk of CVD.
b. What is advised for someone classified this way according to the 2013 AHA/ACC/TOS
guideline?
a. It is advised the patient lose weight when classified as class II.
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a. What is the AHA/ACC/TOS cut-point for abdominal obesity?

a. The AHA/ACC/TOS cut-point is greater than or equal to 88cm (35in) for women.
For men it is greater than or equal to102cm.
a Would Mrs. Sparrow be classified as having abdominal obesity according to the 2013
guideline?
a. Mrs. Sparrow would be classified as having abdominal obesity because her waist
circumference is 5 inches greater than the 35inch cut-point at 40inches.

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.
a. 118 + (6 x 3) = 136#
136 (136 x .1) = 122.4#
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.
a. Miller: 135.1 (-135.1 x .1) = 121.6# Calculator.nets answer is 0.8# less than
what I had calculated.
b. Robinson: 130.5 (-130.5 x .1) = 117.5# 4.9# less than my calculation
c. Devine: 130.7 (-130.7 x .1) = 117.6#... 4.8# less than my calculation
d. Hamwi: 129.4 (-129.4 x .1) = 116.5#... 5.9# less than my calculation
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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?
a. The highest IBW is the Miller equation.
b. The healthy range for BMI is 18.5-24.9:
i. Miller: (121.6# / 66in^2) x 705 = 19.7 BMI This is still in the healthy range
ii.Robinson: (117.5# / 66in^2) x 705 = 19.0 BMI This is still in the healthy
range
iii.
Devine: (117.6# / 66in^2) x 705 = 19.0 BMI This is still in the health
range
iv.
Hamwi: (116.5# / 66in^2) x 705 = 18.9 BMI This BMI is very close to
being below the healthy 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?
a. (CBW/UBW) x 100
(225/250) x100 = 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?
a. (UBW CBW) / UBW
(250 225) / 250 = 0.1% Mrs. Sparrow lost 10% of her usual body 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)?
a. According to the White, JV et al. table, Unintentional Body Weight Change Due to
Illness or Injury as an Indicator of Malnutrition, (slide 27) Mrs. Sparrows 10% BW
change in 3 months is classified as being severely malnourished. Her change in 3 months
was greater than 7.5%. She would have been moderately malnourished if her body weight
change was less than 7.5%. Furthermore, I picked this table as apposed to the Chronic
Illness or Social/Environmental Circumstances table because her illness was acute.
Regardless, the values are the same.
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.
REE = [9.99 X wt (kg)] + [6.25 X ht (cm)] - [4.92 X age] -161
[9.99 x (225 x 0.45)] + [6.25 x (66 x 0.025 x 100)] [4.92 x 40] 161
1011.5 + 1031.3 196.8 161
1685
TDE = REE x AF x IF
1685 x 1.3 (not ambulatory, normally activeno additional exercise) x 1 (no injuries)
2190.5 2200 kcal per day

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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)
REE = [9.99 X wt (kg)] + [6.25 X ht (cm)] - [4.92 X age] -161
[9.99 x (225 x 0.45)] + [6.25 x (66 x 0.025 x 100)] [4.92 x 40] 161
1011.5 + 1031.3 196.8 161
1685
TDE = REE x AF x IF
1685 x 1.1 (confined to bed) x 1.35 (skeletal trauma)
2502.22500 kcal per day
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?
1. TDE prior to injury TDE after injury = kcal difference/day (Kcal diff/day) X # days = total
kcal difference during recovery period
Total kcal diff/kcal per pound = # lbs gained (+) or lost (-)
2. 2200 kcal 2500 kcal = -300 kcal diff/day
(-300kcal) x (30 days) = -9000 kcal difference during recovery period
(-9000kcal)/(3500 kcal/lb) = -2.6 lb lost in 30 days
2.6/ (225lb wt prior to injury) x 100 = 1.2% loss in 30 days
b. Should you be concerned? Why or why not? Be sure to cite your sources!
i. Yes, according to the White, JV et al. chart for Unintentional Body Weight
Change as an Indicator of Malnutrition, Mrs. Sparrow has a weight change that is
<5% at 1.2%. This would place her in the moderate malnutrition category.