BACKGROUND:

Tanya is a 14-year-old high school student who likes reading, singing and browsing the web.  She is 5'4" tall, weighs 190 pounds and usually watches 2-3 hours of TV a day.  Her mother works two jobs and usually is not home in the evening.  Since she qualifies as low income, she participates in the national school lunch program and regularly eats breakfast and lunch at her school.  Tanya relies on prepared or fast food for dinner most nights and often opts to stop at the corner store to get a snack on her way home from school.  Tanya's mother is worried about her increasing weight and took her to doctor.  A checkup revealed the following values:

1. Blood Pressure- 125 mmHg systolic and 85 mmHg diastolic

2. Fasting Blood Glucose -130 mg/dL

3. Triglycerides- 280 mg/dL

4. Cholesterol - total 275 mg/dL; HDL- 25 mg/dL; LDL- 150 mg/ dL

5. Hematocrit- 35%

6. Hemoglobin- 12 g/dL

INSTRUCTIONS:

Based on the background information above, Tanya's 3-day food record, the reference lab values and the additional supportive papers please answer the following questions.Based on your analysis, please answer the questions on the next page.  When preparing your document, please keep the questions.  The easiest way to do this is to simply use this modifiable word document as a template and fill in your answers below the questions. 

QUESTIONS 1-10:

1. List at least FOUR empty calorie foods from Tanya's 3-day food records and suggest a replacement.

2. Describe and comment on Tanya's carbohydrate consumption and comment on how it could be contributing factor to her obesity. Hints/thoughts: Is she consuming refined carbohydrates? Too much soda?  How can she increase her whole grain consumption?  Is she getting enough fiber? 

3. Tanya's fruit intake meets the recommended level.  Do you have any recommendations/comments about her fruit intake (type, food source)?  Why or why not?

4. For two days, March 30 and March 31,Tanya ate the breakfast and lunch provided to her by the school and in accordance with USDA guidelines.  Look at her breakfast and lunch for those days and write a few sentences expressing your opinion on the national school lunch program and mention at least 1 pro and 1 con.

5. Is she getting enough calcium or vitamin D?  Why/how are these minerals important in bone health?

6. What can you say about her bone development at present & her risk of osteoporosis later in life?  What changes can she make in her diet and lifestyle to improve her bone health?

7. What risk factors does Tanya have that increase the chance she will develop cardiovascular disease? Can she modify any of these factors by altering her diet?  Give specific examples.

8. Beside cardiovascular disease and osteoporosis, what other health concerns should Tanya be worried about?  Why?

9. What are three lifestyle (non-dietary) changes Tanya needs to make to decrease her chance of developing chronic diseases?

10. Using Tanya's case as an example, explain how poverty can affect dietary choices and nutrition habits in children/adolescents.