CHAPTER 4 Flashcards
State of health of an individual as it relates to how the diet could meet the daily nutrient requirements.
Nutritional status
Evaluation of the nutritional status of individuals and populations through measurements of food and nutrient intake and evaluation of nutrition-related health indicators
Nutritional assessment
A systematic approach to collect, record, and interpret relevant data from patients, clients, family members, caregivers and other individuals and groups.
Nutritional assessment
The process of identifying characteristics which are associated with nutrition problems
Nutritional Screening
A systematic problem-solving method that dietetics professionals use to critically think and make decisions to address nutrition related problems and provide safe and effective quality nutrition care.
Nutrition Care Process
Four steps of NCP
Assessment, Diagnosis, Monitoring and Evaluation, Interventions
Epidemiological investigation of the nutritional status of a population by various methods
Nutritional Survey
useful in establishing baseline nutritional data and/or ascertaining the overall nutritional status of the population
Nutritional Survey
Continuous monitoring of the nutritional status of selected population groups
Nutritional Surveillance
Useful in identifying causes of malnutrition, can be used in formulating and initiating intervention measures
Nutritional Surveillance
Involves comparing of an individual’s measurements with predetermined risk levels of “cut-off” points
Nutrition Screening
Less comprehensive than survey or surveillance
Nutrition Screening
Methods of nutritional assessment
- Anthropometry
- Biochemical
- Clinical
- Dietary
Measurement of variations of the physical dimensions and gross composition of the human body at different age levels and degrees of nutrition
Anthropometry
Classification of anthropometric measurements
Growth Measurements and Measurements of body composition
Growth Measurements
- Length
- Stature
- Weight
- Body Circumferences
- Birthweight
Measurements of body composition
- Direct
- Indirect
height usually for infants and children up to two years old
recumbent length
Also known as standing height
Stature
An imaginary line between the bony socket of the and external opening ear; “looking straight ahead”
Frankfort plane
The sum of the protein, fat, water, and bone mineral mass.
Weight
These circumference measurements are the same at six months of age
Head and Chest Circumference
Measured just above the eyebrows, above the ears and around the circumference of the head
Head Circumference
Indicator of maternal malnutrition and the status of the infant at birth.
Birthweight
<2500 grams birth weight
Low Birthweight
denotes birthweight less than 10th centile in weight expected for gestation
Small for gestational age (SGA)
<1500 birth weight
very low birth weight
term applied to infants with weight less that two standard deviation below the mean population for a given gestational age.
intrauterine growth retardation
> 4000 grams birthweight
High Birthweight
condition of high birthweight where mothers were obese or diabetic during pregnancy
Macrosomia
it is the reference limit
Cut-off points
refers to the position of the measurement value in relation to all (100%) of the measurements for the reference population, ranked in the order of magnitude.
Percentile
Values considered to be normal or acceptable which are used for comparison with measures obtained.
Reference Standards
The growth reference data for children aged 0-5 years
WHO 2005 Child Growth Standards
reference standard to be used for children 6-18 years.
2007 Reference Table
Used to indicate acute malnutrition for children under 72 months (3 years)
Weight-for-age
Used to indicate stunting
Length/Height-for-age
indice that can differentiate stunting and wasting
Weight-for-Height (WFH)
Weight/height2 (squared)
Body Mass Index
Measured around the upper arm between the acromion process (tip of shoulder) and the olecranon process (tip of elbow
Mid-Upper Arm Circumference
Tools used to Monitor and interpret changes in weight and height measurements over time
Growth Charts
sign of adequate growth
Upward Direction
indicates that the child is not growing, a warning sign
Flat Curve
danger sign, indicates child is losing weight
Downward curve
Refers to the sum of SAM and MAM at a population level
Global Acute Malnutrition (GAM)
Person’s actual weight divided by the reference weight for person’s height and multiplied by 100.
Relative Weight
Weight associated with food health
Desirable Body Weight
Underweight BMI Cut-off point
<18.5
Normal BMI Cut-off point
18.5 – 24.9 / 18.5 – 22.9 (AP)
Overweight BMI Cut-off point
25.0 – 29.9 / 23.0 – 27.5 (AP)
Obese BMI Cut-off point
≥ 30.0 / ≥ 27.5
Proxy Measure for height
Arm Span & Knee Height
Measured with elbow breadth and wrist circumference.
Frame Size
Used to screen undernutrition among adults
Mid-Upper Arm Circumference
Proxy indicator of body fat distribution, specifically central adiposity
Waist Circumference
Indicator of body fat distribution
Waist-Hip Ratio
2 classifications of waist-hip ratio
o Apple or Android – more abdominal fat
o Pear or Gynoid
Indicator of the nutritional status of women during pregnancy and of the fetus.
Weight gain
Estimate of the body’s reserves for fat, protein, water, and several minerals.
Body Composition
Contains 14% water, nearly 100% free of the electrolyte potassium and assumed density of 0.90 g/cm3
Adipose tissue (Fat mass)
Composed of bone marrow, muscle, other fat-free tissue, and body water; 72-74% water content, density of 1.1 g/cm3.
Fat-free compartment
Estimates the thickness of subcutaneous fat in different body landmarks
Skinfold measurement
method of assessing body composition by measuring the density of the whole body. Usually through underwater or hydrostatic weighing
Densitometry
modification of underwater weighing which uses air principle
Plethysmography
Uses a low frequency alternating electric current that passes on one foot and another on the wrist where there is a voltage sensor
Bioelectrical Impedance
Originally for measuring bone density but is also used in measuring soft tissue
Dual-energy X-ray Absorptiometry (DEXA)
An index of fat-free mass, based on the assumption that the fat-free mass has a constant amount of potassium.
Total Body Potassium (TBK)
Uses a tracer dose of water, labeled with deuterium, tritium or 18O which is given orally or intravenously
Total Body Water Using Isotope Solution
A measure of the amount of nitrogen, hence protein (N x 6.25) in the body
Neutron Activation Analysis
Imaging technique providing detailed cross-sectional images of the body due to the differences in transmission through different tissues of the body with different densities.
Computerized Tomography
Allows both imaging of the body and in vivo chemical analysis without hazard to the subject
Magnetic Resonance Imaging (MRI)
Inexpensive method that can be used in imaging
Ultrasound
Provides the most objective and quantitative data or nutritional status
Biochemical assessment
2 classes of biochemical assessments `
Static and Functional tests
assessed by delayed hypersensitivity response tests which involves injection of specific antigens dermally and noting the induced response
Immunocompetence
impaired in mild zinc deficiency
Taste acuity
assess change in the contractility of the muscles
Muscle function test
based on the percentile values of a reference sample of a healthy person in a national survey
Reference distribution
Type of evaluation that is used in the evaluation and monitoring of an intervention program to see the shift in percentile value of an indicator
Reference limits
Assessment of protein status
- Creatinine Excretion and Creatinine-height index
- Serum Proteins
- Nitrogen balance
most readily available clinical test could indicate protein depletion
Serum Albumin
a transport protein containing iron; not reliable for infective conditions, surgeries, etc.
Transferrin
also known as transthyretin and thryoxing-binding prealbumin
Pre-Albumin
aka somatomedin C
Insulin-like Growth factor-1
acute-phase protein that is synthesized in the liver
C-reactive protein
most common measure of vitamin A
Serum Vitamin A
Considered both a nutrient and a prohormone
Vitamin D
most valid estimate of vitamin D
Serum 25-hydroxyvitamin D
Also known as Vitamin B1; a component of the coenzyme TPP which is important in carbohydrate metabolism
Thiamin
Thiamin level can be assessed through:
Urinary Thiamin
Blood Pyruvate level
Erythrocyte transketolase activity (ETKA)
Component of two enzymes: Flavin mononucleotide and Flavin Adenine Dinucleotide
Riboflavin
Three forms of Vitamin b6
Pyridoxine, Pyridoxal, & Pyridoxamine
most frequent biochemical indicator for vitamin b6 status
Plasma and Erythrocyte Pyridoxal 5’- Phosphate (PLP)
most widely used indicator for vitamin b6
Tryptophan load test
Folate level can be assessed through:
Serum Folate
Erythrocyte Folate – best clinical index of depleted folate stores
Deoxyuridine test
Iron level can be assessed through:
- Serum Ferritin level
- Transferrin Saturation
- Hemoglobin
- Hematocrit – amount of hemoglobin in rbc
- Mean Corpuscular hemoglobin
- Mean corpuscular volume
closely reflects iodine intake and has been used as an index of iodine nutriture in many large scale survey
Urinary Iodine Excretion
leading cause of mortality
HPN and CVD
Also known as chemistry profile, chemistry panel, chem panel.
BLOOD CHEMISTRY TESTS
deals with the examination of the changes that can be seen or felt in the superficial tissues.
CLINICAL ASSESSMENT
technique for assessing nutritional status based on medical and physical examination.
Subjective Global Assessment
Goiter Classification
0 – no visible goiter
1 – not visible when the neck is in normal position
2 – swelling in normal position
a study or activity or intended to measure the quantity and quality of diets of individual or population or groups in a particular area for given period of time
Dietary Assessment
collection of formation on quantity of food consumed as it enters the kitchen or used for the participation of meals which is in sufficient detail to permit calculation of nutritive value of the diet.
Household food consumption
A rough estimate of food supplies available for consumption at the national level.
Food balance sheets
Methods of collecting food consumption data in household Level
o Food Account
o Food Inventory
o Household Food Record
Aka food weighing method
Household Food Record
A detailed record food entering the household including produced food, gifts, and from other sources. Foods consumed outside home are excluded.
Food Account
method that is widely used in case-control or cohort studies for collecting food consumption data
Food Frequency Questionnaires
Referred to the collection of information not only about the frequency of intake of various foods but also about the typical makeup of meals.
Diet History
Nutritional screening tool to evaluate the frail elderly.
Mini Nutritional Assessment
Is a general term to denote a set of reference values that are quantitative estimates of nutrient intakes to be used for planning and assessing diets for apparently healthy people
DIETARY REFERENCE INTAKES (DRI)
also called RDA, is the intake that is sufficient to meet nutrient requirements of nearly all healthy individuals in all stage and sex group.
Recommended Energy and Nutrient Intake (REI & RNI)
average daily intake level estimated to meet the nutrient requirements of half the healthy individuals in a particular life stage and sex group
Estimated Average Requirement (EAR)
nutrient intake level that is based on observed or experimentally-determined approximation of the average nutrient intake of apparently healthy people.
Adequate Intake (AI)
highest average daily nutrient intake that poses no adverse health effects to almost all individuals in the general population.
Tolerable Upper Level of Intake or Upper Limit (UL)
range of intakes for a particular energy source that is associated with reduced risk of chronic disease while providing adequate intakes of essential nutrients.
Acceptable Macronutrient Distribution Range
Index of adequacy of nutrient intake based on RENI/RDA for that nutrient
Nutrient Adequacy ratio
Measure of the individual’s nutrient intake in relation to the distribution of corresponding nutrient intake of the group
Standard Deviation or Z-score
Reflects household access to a variety of foods, and also a proxy for nutrient adequacy of the diet of individuals.
Dietary Diversity score
Components of food security
o Food availability
o Food access
o Food utilization
Number of reported cases of a given disease present at given time per 100,000 population
Morbidity rate
Refers to the frequency of occurrence or assessment of a particular disease during a year or a given period of time
Incidence Rate
Refers to the proportion of population or a group who are actually ill with a particular disease or infection.
Prevalence rate
Slowness of heartbeat
Bradycardia
Presence of lesions of the lips
Cheilosis
impaired secretion of the sebaceous glands
Dyssebacea
Inflammation of the eyelids
Palpebritis
Inflammation of the mouth
Stomatitis
Clinical condition of a dry or scaly surface may be due to nutritional deficiency
Xerosis
How many food groups are there?
12
number of food groups for women
9
lowest diversity value
less than or equal to 3 groups
medium dietary diversity
4-5 food groups
high dietary diversity
more than or equal to 6 groups