Question

Sam is a 14-year-old male who is being seen by you today on the advice of his pediatrician. Sam’s parents are divorced and he splits his time between the two households. His mother has become increasingly concerned that he is spending too much time exercising and not enough time with his friends. His father thinks his mother is overreacting. When you talk with Sam about his eating habits, you find out that he is a vegan. On questioning, you discover that he became a lacto ovo-vegetarian at the age of 11 because he was concerned about animal welfare. Sam’s diet became increasingly restrictive over the next 2 years as he attempted to reduce the fat intake in his diet. He has been vegan for the past 14 months. His mother has been a vegetarian for as long as he can remember, but his father eats poultry and fish. Sam reports that he runs 1-to-2 hours a day 5 to 6 days a week. When he is not able to run due to the weather, he walks the stairs at his school or uses his father’s exercise machines. Sam reports that he runs because it makes him feel good and because it helps him to keep fit. He mentions that he has begun lifting weights to try to “bulk up,” but that hasn’t been effective so far. Sam’s medical chart shows that his BMI percentile has dropped from the 45th percentile in the past 8 to 9 months. His hemoglobin and hematocrit are at the low end of normal, and his blood pressure is low. Nutrition Diagnosis 1: Excessive exercise related to mom’s concerns that exercise is impacting social development as evidenced by running 1 to 2 hours daily and weight loss. What concerns do you have regarding Sam’s decision to follow a vegan diet, given his age and lifestyle? On the basis of these concerns, what advice would you give him? What are the energy and protein needs for a male of Sam’s age? What types of foods would you recommend that he consume if he continues to follow a vegan diet? What referrals would you make based on Sam’s information?

Nutrition Subject

Answer 1