Lecture 9

Question 1

Define nutritional status

Answer 1

Balance between nutrient intake and expenditure

Question 2

What do measures of nutritional status indicate?

Answer 2

Intake, absorption, metabolism, storage, and excretion

Question 3

What are the two types of assessment?

Answer 3

Individual level: diagnosis, screening, intervention, monitoring
Population level: policy setting, programme evaluation, nutritional surveillance

Question 4

What is the ABCDE of nutrition assessment?

Answer 4

• Anthropometric
• Biochemical
• Clinical
• Dietary
• (Economical/Social)

Question 5

What does anthropometry involve?

Answer 5

Changes in physical dimensions (weight) and body composition – including rate of change

• Weight
• Height/Stature/knee height/total arm length/arm span
• Circumferences

Question 6

Give some examples of invasive antropometric measurements

Answer 6

• Skinfolds
• Total body electrical conductivity
• Magnetic resonance imaging

Question 7

What is the equation for calculating BMI?

Answer 7

Weight/(Height^2)

Question 8

What is the normal range of BMI?

Answer 8

18.50 - 24.99

Question 9

What is the overweight range of BMI?

Answer 9

25.00 - 29.99

Question 10

What is the equation for percentage weight loss?

Answer 10

(Usual weight - current weight (kg) x 100)/usual weight

Question 11

What is often more relaible that standard tables for estimating weight loss?

Answer 11

Recalled well weight

Question 12

What is body weight made up of?

Answer 12

Fat + lean tissue (including water)

Question 13

What is the ideal body fat for men and women?

Answer 13

Men 12-20% body fat

Women 20-30% body fat

Question 14

What percentages lead to increased health risks in men and women?

Answer 14

> 22% fat in young men and >25% in men over 40

>32% in young women and >35% in women over 40

Question 15

What ratio correlates with body fat? What standards are there for increased mortality risk?

Answer 15

Waist:hip ratio

Increased mortality risk > 0.8 women, >1.0 men

Question 16

What are the standards for waist circumference that indicate increased mortality risk?

Answer 16

> 88cm women

>102cm men

Question 17

What is biochemical assessment used to test for?

Answer 17

• To detect subclinical or marginal deficiencies
• To enhance or support other nutritional data
• Nutrients in blood or urine, biopsy
• In vivo response to nutrient supplementation e.g Hb and iron

Question 18

What does serum albumin level measure?

Answer 18

Main protein in blood. Determines protein status.

Question 19

What does serum transferrin level measure?

Answer 19

Indicates iron-carrying protein in blood

Question 20

What does clinical assessment detect?

Answer 20

• Detect signs and symptoms of malnutrition. Whether likely to be reversible

Question 21

When are deficiencies usually clinically evident?

Answer 21

When it is severe

Question 22

What may symptoms of deficiencies also be caused by?

Answer 22

• Symptoms may be caused by non-nutritional factors – secondary deficiency
• Symptoms may relate to several nutrients

Question 23

What does a clinical assessment involve?

Answer 23

• Medical history
• Physical assessment: hair, skin, eyes, mouth, bones
• Physiological Tests e.g. Immune competence, taste, acuity, night blindness, muscle function, cognitive function, dental health (affects chewing and swallowing)

Question 24

Outline the review of systems

Answer 24

General: appetite canges, weight loss/gain, clothes tighter/looser
Skin: appearance
GI symptoms/alimentary: abdominal pain, nausea, vomiting

Question 25

What is observed or reported in dietary evaluation?

Answer 25

Measurements of food consumption observed/reported

• Food and beverage intake – quality of diet
• Food consumption patterns (changes and trends) and preferences
• Usage of supplements (and effect on nutrient
• Feeding practices e.g. institutions
• Food security/insecurity: not enough money to buy the required food
• Economical/social: limited ability to cook food

Question 26

What are the 4 main methods of dietary evaluation?

Answer 26

1. Diet (food) History
2. Food Frequency Questionnaire
3. 24 hour recall
4. Food records

Question 27

What is the intake recorded in dietary assessment compared to?

Answer 27

• Recommended Dietary Intakes for age and gender
• Food and Nutrition Guidelines- recommended servings of food groups
• Healthy Eating plate models and Dietary Pyramids

Question 28

What is the normal haemoglobin range?

Answer 28

115-160 g/L

Question 29

What is Goiter?

Answer 29

Enlarged thyroid due to iodine deficiency

Question 30

Outline the Subjective Global Assessment Scoring Sheet

Answer 30

Gives score depending on weight change and food intake change, GI symptoms and physical examinations. Overall classification determines level of nourishment.