NUTRITIONAL ASSESSMENT Flashcards
What is Nutritional Assessment?
- Methods used to determine nutritional status amongst populations
- Often used at national level
- Includes 4 components: Clinical, Dietary, Anthropometry and Biochemical
Name the 4 types of nutritional assessment systems and describe them.
- ) Surveys: Provide a cross sectional snapshot of a target population’s dietary patterns
- ) Surveillance: Continuous monitoring of target populations where obtained data is then analysed
- ) Screening: Comparison of individuals measurements to predetermined risk factors and guidelines
- ) Interventions: Used to target population subgroups at risk
How are results of community level assessment obtained?
Estimations are created using information from food bank usage, average household income, age distribution. Opinions of local health professionals are also used.
The results obtained are then used to create community wide programs such as childhood obesity monitoring and iron deficiency prevention.
Discuss the 4 screening tools used in clinical assessment of nutritional status.
- ) WAVE (Weight, Activity, Variety, Access): Used to promote a patient-practioner dialogue. Pros and cons of patient’s current nutritional status is discussed.
- ) REAP (Rapid Eating and Activity of Patient): Brief questionnaire.
- ) MUST (Malnutrition Universal Screening Tool): Uses objective measurements to establish nutritional risk and obtain a score.
- ) MNA (Mini-Nutritional Assessment): Uses easy to obtain data to assess risk of malnutrition in patients and assess whether they need further nutritional assessment.
What is clinical assessment of nutritional assessment?
Physical observations made by a qualified practioner that give an indication of nutritional related problems.
Collecting medical history of the patient is also used.
Discuss the 2 types of medical records.
SOMR (Source Orientated Medical Records): Organised by source such as medication.
POMR (Problem Orientated Medical Records): Organised by problem. Allow specific conditions to be tracked and allow clinical hypothesis and decisions to be made by practitioners.
What are the 2 types of Dietary Assessment?
Retrospective
Prospective
Discuss the pros and cons of retrospective methods of dietary assessment.
Examples: 24hr dietary recall, food frequency questionnaire, dietary history
Pros: Quick, easy, non-invasive
Cons: Based on memory, require a trained interviewer, misreporting
Discuss the pros and cons of prospective dietary assessment.
Examples: Weighed food records, estimated food records (household level), weighed food records combined with chemical analysis.
Pros: Most accurate as not reliant on memory, takes into account food waste
Cons: Require cooperation from participant, require literacy and numeracy skills of participant, participant must be trained
What is anthropometrical nutritional assessment and why is it carried out?
-Human body measurements used to breakdown the body into its 4 principal components: fat, lean muscle, water and bone.
Used to
1- Investigate body composition and fat distribution
2- Determine effects of weight loss and weight gain on body composition
3- Estimate energy requirements
4- Understand and identify wasting
How should waist circumference by measured?
- On bare skin
- At midpoint between iliac crest and lower rib
Discuss the pros and cons of waist circumference.
Considered best in patients with a BMI between 25-35 (overweight)
Pros: better than W2HR as simultaneously correlates with whole body
Cons: Invasive and involves cultural sensitivity,
Discuss pros and cons of skinfold calliper thickness.
Pros: Can measure subcutaneous fat in areas of the body and can be used to assess whole body fat if relationship is assumed constant.
Cons: Requires trained examiner, high error in old and obese patients, invasive as required to undress and involves cultural sensitivity.
What are biochemical tests used for?
To confirm clinical diagnosis and detect subclinical deficiencies
Discuss the 2 types of biochemical tests.
- ) Static tests: measurement of nutrient or its metabolite in human samples.
- fails to reflect overall nutrient status.
- urine and blood are not invasive, cheap and easy to analyse - ) Functional tests: based on the idea that nutrient deficiency can be assessed by the failure of 1 or more physiological processes that rely upon that nutrient.
- not specific
