Lecture 11 Flashcards

How good is this persons nutrient intake ?

1
Q

4 steps to nutritional assessment

A
  1. anthropometric assessment
  2. dietary assessment
  3. biochemical assessment
  4. clinical assessment
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2
Q

dietary assessment alone is

A

not enough to work out someones nutritional status

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3
Q

what is the appropriate use of the EAR (individuals)

A

use to examine probability that usual intake is inadequate

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4
Q

what is the appropriate use of the RDI (individuals)

A

usual intake >- this level has low probability of inadequacy (not so good for use for individual)

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5
Q

what is the appropriate use of the AI (individuals)

A

usual intake >- this level has a low probability of inadequacy

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6
Q

what is the appropriate use of the UL (individuals)

A

usual intake > this level may place an individual at risk of adverse health affects

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7
Q

for nutrient adequacy in individuals, in an ideal world you would compare ….. BUT

A
  • individuals long term usual intake
  • individuals requirement

but we dont know either so

  • individuals observed intake
  • best guess at their requirement = EAR
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8
Q

we dont know individuals long term intake of requirement which means we can only get their ….. and what is this

A

apparent adequacy

“an estimate of the confidence one has that usual intake is above (or below) an individuals requirement”

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9
Q

what are the 3 steps to the quantitative approach for nutrient adequacy in individuals

A
  1. obtain info on indivuals usual intake
  2. choose an appropriate reference standard
  3. determine apparent adequacy
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10
Q

what is step one in the quantitative approach for nutrient adequacy in individuals

A

obtain info in individuals usual intakes:
- calculate individuals mean intake

  • find an estimate of day to day variation in intakes (ideally national data - e.g IOM tables
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11
Q

what is step two in the quantitative approach for nutrient adequacy in individuals

A

choose an appropriate reference standard

EAR = best guess of individuals actual requirement
RDI = not recommended, dont know the individuals usual intake
AI = can use if thats all you’ve got

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12
Q

what are the 3 equations used to determine apparent adequacy (quantitative approach for nutrient adequacy - individuals) = using EAR example (ideal), and what should we do with this answer

A

D = y - r

SD(D) = square root of (Vreq + (Vwithin /n))

D / SD(D) =

compare this answer to IOM table to determine probability of correctly concluding that usual intake is adequate or inadequate

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13
Q

what does D mean in the 3 equations used to determine apparent adequacy (quantitative approach for nutrient adequacy - individuals) = using EAR example (ideal)

A

difference

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14
Q

what does SD(D) mean in the 3 equations used to determine apparent adequacy (quantitative approach for nutrient adequacy - individuals) = using EAR example (ideal)

A

SD of difference

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15
Q

what does Vreq mean in the 3 equations used to determine apparent adequacy (quantitative approach for nutrient adequacy - individuals) = using EAR example (ideal)

A

variance of distribution of reqs in group

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16
Q

what does Vwithin/ n mean in the 3 equations used to determine apparent adequacy (quantitative approach for nutrient adequacy - individuals) = using EAR example (ideal)

A

average variance in day - to day intakes of nutrient

17
Q

when using the AI for individuals - quantitative approach for determining nutrient adequacy it is a similar

A

approach to EAR but can only determine the certainty that intake is > AI

18
Q

when using the AI for individuals - quantitative approach for determining nutrient adequacy it can not tell

A

can not tell u about anything about adequacy of intakes < AI

19
Q

AI is often higher than what and

A

higher than the RDI, there is no information on its distribution

20
Q

the quantitative approach for individuals assumes

A
  • requirements are normally distributed, BUT no for Fe premenopausal women
  • intakes are normally distributed, BUT not for vitamins A, B12, C, E
21
Q

when using the EAR if observed intake is < EAR

A

probably need to increase (Padeq<-50%)

22
Q

when using the EAR, if EAR < observed intake < RDI

A

probably needs to increase

23
Q

when using the EAR if long term observed intake is > RDI

A

probably adequate

24
Q

when using the AI is long term observed intake is >- AI

A

probably adequate

25
Q

when using AI if observed intake is < AI

A

we can’t determine adequacy

26
Q

when using the UL if the observed intake is >- UL

A

potential risk if over many days

27
Q

when using the UL if the observed intake is < UL

A

probably safe is over many days

28
Q

what are the limitations for methods determining individual adequacy

A
  • dont have usual intake or actual requirement
  • assume CV of 10% for SDreq
  • assume SDintake for individual similar to pooled data from CSFII
    assume no low energy reporting
  • dont have EAR for all nutrients

need other nutritional assessment data as well

29
Q

the NRVs are used to determine the probability that

A

an individuals intake meets their own requirement

30
Q

the quantitative approach ideally

A

uses the EAR and can not be used for most nutrients

31
Q

similar approaches can be used for the

A

UL and AI for individuals

32
Q

the qualitative approach provides

A

much less information but has to be used for some nutrients