Nutrition Assessment 1 Flashcards
Why do we need more protein in weightloss diets?
because we use some of our protein for energy
Anthropometrics
body size, weight, and proportions
- used to evalute nutritional status and evalute intervention
- includes measurements of body weight, height, triceps skinfold, abdominal circumference, calf circumference, midarm muscle circumference and area (MAC and MAMA), elbow breadth, and subscapular skinfold.
- can provide an estimate of body compartments but not as accurate of direct methods
- information about the distribution of body fat and skeletal muscle mass, and over time, identify nutritional deficiencies or excesses in calorie and protein reserves compared with standardized percentiles. Anthropometry is considered as an indirect method which provides estimates or indices of body composition and tends to have larger predictive errors than direct methods including computed X-ray tomography (CT), magnetic resonance imaging (MRI), and DXA
body composition
think 2 compartments: fat -free and fat mass
- can be measured through anthropometrics: skinfold measures ( indirectly - not as accurate as other techniques such as DXA
- fat-free includes: muscle, blood, organs etc
- or could do 3 models: fat-free, fat mass and bone masss
skin fold measures
used to estimate energy reserves- fat and somatic protein - in subcutaneous tissue
- callipers and tape measure
- chest, triceps,subscapular, midaxillary, supra iliac, abdomen, thigh, calf
- campare to data that is age, sex and race specific
interpreting skin fold thickness data
below 5th %tile or above 95%tile may be at nutritional risk
important to remember when interpreting skin fold thickness data
these tables were made in healthy ppl, can’t be used in disease state.
BIA
small electric current
- body cell mass, fat-free mass, fat mass, total body mass
assessment vs screening
assessment of body compartments and analysis of structure and function of organ system and their effects on metabolism
screening to identify characteristics that could be associated with nutritional problems. identify patients, client, groups who may benefit from nutrition assessment
goal of assessment
to identify patients needing nutritional support
- disease prevention, identify defeciency, overall malnutrition
malnutrition affects more than ___% of hospitalized pateints
50%
initial screening
- pre-existing conditions causing nutrient loss
- conditions that increase nutrient requirements
- dietary intake
- weight loss
how do we assess
ABCD and F
anthropometrics biochemical clinical dietary functional
how do we evaluate anthropometric data
BMI
NHANES I and II reference tables
nurtition canada reference tables - 5% and 95% suggest nutritional risk
how do we evaluate biochemical data
cut-off values, normal lab values
how do we evaluate clinical data
physical signs ( presence of edema)
how do we evaluate dietary data
DRI - canada nad usa same
Canadian food guide
us: USDA food pyramid
explain the development of a nutritional deficiency in stages
- dietary inadequacy - diet
- low tissue reserve - biochemical
- low body fluid level- bio
- low function or tissue- bio or anthem
- low enzyme activity- biochem
- functional changes- behaviour
- clinical symptoms- clinical
- anatomical signs- clinical
this shows the importance of biochemical assessment in detecting a deficiency early before clinical symptoms show up
body composition correlates to
function
normal body composition
muscle- 26 000 kcal
fat- 160 000kcal (6x more)
total protein kg?
12kg in 70 kg man ( including skeleton, extracellular, plasma, visor, skeletal muscle )
why measure frame size
r= height/waist circumference
BMI
kg/m^2
healthy BMI <65
18.5-24.9
BMI limitations
doesn’t measure body composition
varies in relation to age, sex and ethnicity
athletes
need other measures
- it is better than weight and heigh alone but that might be it
% weight change
(UBW- current weight)/ UBW
what to know about % weight change
more than 5% in 1 month indicates nutrition risk, and greater than 10% in 6 months
10-20% lost of weight
loss of some function
more than 20% pre- illness weight
loss of multiple function & PEM
skinfold thickness
indicative of subcutaneous adipose tissue
body circumference and areas reference tables
< 5% MAMA ( muscle deficit) or MAFA ( fat deficit)
> 85% excess fat or above average muscle
was it: hip ratio
estimates distribution of subcutaneous and intra- abdominal adipose and muscle tissue
