Joey – Age 10

Introduction

             This paper will examine the health status, physical characteristics, nutrition and lifestyle of the pseudo-child Joey and suggest motivational strategies, behavior modification and do an exercise prescription.

Health History by parent or guardian

Joey is 10 years old, weighs 80 pounds, is 4’8” tall and has no general medical history.

Risk Factors and Precautions

Joey has no risk factors, therefore a doctors consent is not needed for him to engage in an exercise program.

Medications

Joey is not taking any medications.

Physical fitness test

The results of his physical fitness tests are as follows: Curl ups: 40 = 47^th percentile Rating Poor, Shuttle run: 12sec = Rating Poor, Sit N Reach: 27cm = 43^rd percentile Rating Poor, 1 mile run: 10:35 = 49^th percentile Rating Poor, Pushups: 8 = 55^th percentile Rating Poor

For the fitness tests I used the calculators at ExRx (ExRx.net LLC, 2012).  I couldn’t find a one mile run so I used the 2 mile run and doubled the amount listed for the 1 mile run. According to these calculators Joey scored poor on all the tests.

Health and Lifestyle Related Behaviors

Joey participates in basketball and baseball at school and likes skateboarding and playing with friends, but also loves his PlayStation and computer games.

Body Composition

Since Joey is 4’8” tall and weighs 80 pounds his BMI. Using the CDC’s BMI calculator for children, Joey’s BMI is 17.9.  He is in the 71^st percentile for boys his age which is in the healthy weight range (Center for Disease Control, 2011).

Nutrition

Joey typically grabs a granola bar for breakfast, eats pizza or some other hot lunch at school, and a big dinner. He loves ice cream and chips. He doesn’t like vegetables but will eat fruit.

Based on a low activity rate, Joey’s average calorie intake should be 2086 to maintain his current weight (Princeton Living Well, 2007).  I would, therefore, recommend a daily caloric intake of at least 2200 because in order for him to gain the weight that he needs to as he ages and to be able to support a more active lifestyle.

Although Joey diet on the surface appears very bad, there are some positives. If he eats hot lunch at school, he is getting a significant portion of the nutrients that he needs because of the improvements in the school lunch program guidelines. Even when they serve pizza they are required to serve a fruit and a vegetable with it (Department of Agriculture, 2012).

I would suggest to Joey that if he is going to grab a granola bar, that he at least add a glass of milk and a piece of fruit to his breakfast.  I would also suggest that he consider some healthier alternatives for a quick breakfast such as whole wheat peanut toast with milk and fruit.

Even though eating hot lunch at school is not as bad as it used to be with the new school lunch guidelines (Department of Agriculture, 2012), but I would suggest that he and his parents look at the school lunch menu each week and make sure that what is being served are things that he likes and will eat. If not, then packing a lunch would be a good idea.

Another suggestion that I have is that his parents do not keep chips or ice cream in the house as snacks and instead have fruit, raw vegetables, string cheese and yogurt available for afterschool snacks because if they are having a late dinner and since school lunch are typically served before noon, Joey is going to be hungry when he gets home from school and these snacks are a good way to improve his nutrition and get some extra calories into his diet. Also, if Joey has a snack after school, he will not be as hungry at dinner time and will not have to eat such a large dinner. Ice Cream could be used as an occasional treat or a reward for physical activity.

In addition at dinner time, I would suggest that his parents try to sneak some vegetables into things that he already likes. For example, puree carrots and add them to spaghetti sauce. It would also be good if they served raw vegetables and salads because even kids who are not fond of vegetables will usually eat them raw in salads or with dips.

Motivational Strategies

While Joey participates in basketball and baseball in school and likes skateboarding, it appears that he does not have any regular physical activity that he participates in. I would suggest that he become involved with a basketball or baseball league so that he could have an activity that he regularly participates in. It also would be helpful for him to join the President’s Challenge or use some other site to track his physical activity to be sure that he is getting the recommended 60 minutes of activity a day. This would also help him to have a goal to work toward and provide a method of rewarding himself (Marcus, B., & Forsyth, L., 2010).

I would also enlist his parents to provide social support to help him become involved in a sports league and also ask them to play with him to encourage him to be more physically active Marcus, B., & Forsyth, L. (2010).  Another thing that I would ask of them is that they monitor his computer and PlayStation time in order to ensure that he is not inactive for more than 2 hours per day (Howley, E. T., & Franks, B. D., 2007).

Evaluation and Recommendations

            I would recommend that Joey modify his behavior to include regular physical activity and that his activity be tracked in order to insure that he is getting the recommended 60 minutes per day and that he vary his activity in order to improve his scores on the fitness test by doing such things as practicing sit-ups and pushups.

Exercise prescription for Joey:

 

Frequency	Intensity	Type	Time
Daily	Low	Walk to school	30 minutes
3 days a week	Moderate	Ride Bike with friends or family	30 minutes
1 day a week	Moderate	Physical Education Class	30 minutes
3 days a week	Moderate	Skateboarding with friends	30 minutes
3 days a week	Moderate	Shoot baskets with friends or family	30 minutes
2 days a week	Moderate	Play catch with Dad	30 minutes
3 days a week	Moderate	Practice curl-ups and pushups with Dad	30 minutes
5 days a week	Moderate	Plays on playground at school, climbing, playing on monkey bars and running around	45 minutes
1 day a week	High	Little League or basketball game	60 minutes

In conclusion, Joey’s parents and I need to work to insure that he is getting the recommended 60 minutes of activity per day, to improve his scores on the fitness tests, encourage him to be more physically active and offer him support and reward his efforts. By doing so, he will become more fit and improve his overall health status.

References

Center for Disease Control. (2011, September 11). Bmi percentile calculator for child and teen . Retrieved from http://apps.nccd.cdc.gov/dnpabmi/

Department of Agriculture. (2012, January 12). Nutrition standards in the national school lunch and school breakfast programs; final rule. Retrieved from http://www.gpo.gov/fdsys/pkg/FR-2012-01-26/pdf/2012-1010.pdf

ExRx.net LLC. (2012, August 1st). Exrx fitness testing. Retrieved from http://www.exrx.net/Testing.html

Howley, E. T., & Franks, B. D. (2007). Fitness professional’s handbook. (5th ed.). Champaign, IL: Human Kinetics Publishers.

Marcus, B., & Forsyth, L. (2010). Motivating people to be physically active. Champaign, IL: Human Kinetics Publishers.

Princeton Living Well. (2007). Health calculator: Estimated energy requirement (eer). Retrieved from http://www.princetonlivingwell.com/calculators/eer.aspx