Four year old Jamie often comes to school without having had breakfast at home. Both of his parents work so he leaves home early every day.

Four year old Jamie often comes to school without having had breakfast at home. Both of his parents work so he leaves home early every day. By mid-morning, Jamie is often inattentive, lethargic, and seems to be “off in his own world.” He seldom plays games with the other children and spends most of his recess just standing around. At lunchtime, Jamie tends to select only milk and breads and is resistant to eating most vegetables and meats. What may be the cause of Jamie’s mid-morning behavior? How would you characterize Jamie’s nutritional status? What eating patterns need to be corrected? What steps should be taken to improve Jamie’s participation in activities, as well as his nutritional habits, and health status?