Lecture 9: Nutrition assessment Flashcards
What is nutritional status?
- Balance between nutrient intake and energy expenditure (health condition).
- Reflects, intake, absorption, metabolism, storage and excretion.
How can nutritional status be measured?
Individual level: Diagnosis, screening, intervention and monitoring
Population level: Policy setting, programme evaluation, nutritional surveillance.
How can nutrition be integrated into routine clinical care?
- Past medical history
- Family history
- Medications/supplements/ herbs
- Diet/social history
- Review of systems
- Physical examination
- Lab eval
- Assessment and plan
What is the ABCD (E) of nutrition assessment?
- Anthropometric
- Biochemical
- Clinical
- Dietary
- (Economical/social)
What is anthropometry in nutritional assessment?
Examining changes in physical dimensions and body compositions;
- Rates of change
- Weight
- Height/stature/knee height/total arm length/arm span (Indirect way in children / people who cant stand up)
- Circumferences
What are some invasive clinical anthropometric assessments?
- DEXA
- Skinfolds
- Bioimpedance
- MRI
- Body density (Displacement)
What is body composition?
Body weight: Fat and lean tissue (Including water)
What are the ideal body fat ranges?
Men: 12-20%
Women: 20-30%
What are the health risks and BMI?
Underweight: 18.5
Normal range: 18.5<24.99
Overweight: 25.0<29.99 Increased risk
Obese: 30+ Substantially increased risk
What is a useful measure when it comes to weight?
Change in body weight
What is being looked for in biochemical assessment?
- Detect subclinical or marginal deficiencies
- Enhance/support nutritional data
- Nutrients in blood, urine or biopsy i.e iodine in urine
- In-vivo response to nutrient supl. i.e HB and iron.
What is examined in the clinical evaluation in consideration for nutrition?
- Signs and symptoms for deficiency/toxicity (reversible?)
- Physiological measures, functionality
- Oral and dental health
- Cognitive status
- Drug/supplement/herb history (any interactions) (drugs are over the counter and online etc)
Primary or secondary causes i.e poor dental health leads to poor nutrition vs gut inflammation
What are come clinical assessments?
- Detect signs and symptoms of malnutrition
- Physical assessment; Do your clothes still fit?, hair, skin eyes, mouth, bones
- Physiological tests (immune competence, taste, acuity, night blindness, muscle and cognitive function)
When it comes to clinical assessment, what are some considerations?
- Deficiency usually severe before evident.
- Symptoms may be caused by non-nutritional factors, Secondary deficienies
- Symptoms may relate to several nutrients
Whats required to confirm a deficiency?
Screening tools can be used in a clinical setting and patients identified at risk go on to require a diagnosis to confirm malnutrition.
