Lecture 11

Question 1

4 steps to nutritional assessment

Answer 1

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

Question 2

dietary assessment alone is

Answer 2

not enough to work out someones nutritional status

Question 3

what is the appropriate use of the EAR (individuals)

Answer 3

use to examine probability that usual intake is inadequate

Question 4

what is the appropriate use of the RDI (individuals)

Answer 4

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

Question 5

what is the appropriate use of the AI (individuals)

Answer 5

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

Question 6

what is the appropriate use of the UL (individuals)

Answer 6

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

Question 7

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

Answer 7

• individuals long term usual intake
• individuals requirement

but we dont know either so

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

Question 8

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

Answer 8

apparent adequacy

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

Question 9

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

Answer 9

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

Question 10

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

Answer 10

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

Question 11

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

Answer 11

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

Question 12

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

Answer 12

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

Question 13

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

Answer 13

difference

Question 14

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

Answer 14

SD of difference

Question 15

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

Answer 15

variance of distribution of reqs in group

Question 16

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

Answer 16

average variance in day - to day intakes of nutrient

Question 17

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

Answer 17

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

Question 18

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

Answer 18

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

Question 19

AI is often higher than what and

Answer 19

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

Question 20

the quantitative approach for individuals assumes

Answer 20

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

Question 21

when using the EAR if observed intake is < EAR

Answer 21

probably need to increase (Padeq<-50%)

Question 22

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

Answer 22

probably needs to increase

Question 23

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

Answer 23

probably adequate

Question 24

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

Answer 24

probably adequate

Question 25

when using AI if observed intake is < AI

Answer 25

we can’t determine adequacy

Question 26

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

Answer 26

potential risk if over many days

Question 27

when using the UL if the observed intake is < UL

Answer 27

probably safe is over many days

Question 28

what are the limitations for methods determining individual adequacy

Answer 28

• 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

Question 29

the NRVs are used to determine the probability that

Answer 29

an individuals intake meets their own requirement

Question 30

the quantitative approach ideally

Answer 30

uses the EAR and can not be used for most nutrients

Question 31

similar approaches can be used for the

Answer 31

UL and AI for individuals

Question 32

the qualitative approach provides

Answer 32

much less information but has to be used for some nutrients