Nutritional Assessment Flashcards
What things would you do during clinical care?
past medical history family history meds, OTC/supplements/herbs diet physical examination lab evaluation
What does A B C D E of nutrition assessment stand for?
Anthropometric (physical exam) Biochemical (blood tests) Clinical Dietary Economic/social
What is Anthropometry
changes in physical weight and body composition, this includes rate of change.
- weight
- height/stature/knee height/total arm length/ arm span
Long term weight change means?
a chronic condition such as ‘bowel cancer’
Short term weight change means?
acute condition like ‘diarrhoea’
What are some more invasive techniques rarely used. Why not used?
Skinfolds
bioelectrial impedance
DEXA
body density
Invasive, not enough time, not always accurate
Since there is not usually enough time to do many techniques, what is often used instead?
BMI (weight for height in a suggested range)
calculation of BMI
BMI= weight/height
Why should BMI ever not be used?
For sportspeople with a large muscle mass.
Do all ethnicities have the same BMI scale?
No.
Pacific island/maori: slightly higher
Asian/indian: slightly lower
Calculation to find % weight loss?
% weight loss= (usual weight-current weight x 100) / usual weight
Significant weight loss 1 week 1 month 3 months 6 months
1 week) 1-2%
1 month) 5%
3 months) 7.5%
6 months) 10%
severe weight loss is just over this
Ideal body fat for men and women
Men: 12-20%
Women: 20-30%
When a you at risk for increased health risks?
> 22% fat (young men)
25% fat (men over 40)
> 32% fat (young women)
35% fat (women over 40)
What waist:hip ratio should we be within?
women 0.8
men 1.0
What waist circumference should we be within?
women 88cm
men 102cm
What is the purpose of a biochemical assessment?
to detect subclinical or marginal deficiencies
To enhance/support other nutritional data
Find nutrients in blood/ urine
in vivo response to nutrient supplementation
Unless someone is obese or serverly underweight it is difficult to determine their nutrition status. Instead, what would you do to determine this as a clinical assessment?
sign/symptoms of nutrition deficiency/toxicity
measure physiological performance and activities
oral and dental health
cognitive status
use of drugs
Why can a complete dietary evaluation be difficult to do?
As there is so little time in the clinical setting
What is the first question you would ask?
“hows your appetite been recently?”
Which measurements of food consumption would you observe/report if possible
- quality of diet
- food consumption patterns (24hr recall)
- usage of supplements
- feeding practices
- food security/insecurity
What does the SGA scoring sheet look at?
weight change
food consumption
GI tract
What does the SGA scoring indicate?
6-7 normal/well nourished
3-5 mild/moderate malnourishment
1-2 malnourished
What does a clinical review of systems mean generally?
appetite change, weight change, clothes fitting different, skin appearance (pinch test / liver disease/ beta-carotene)
What does a clinical review of systems mean with the GI tract?
abdominal pain, nausea, vomiting bowel changes difficulty/ pain swallowing indigestion/heartburn oral (mouth lesions, ulcers, tooth decay)
Nutritional status
balance between
nutrient intake and expenditure
Two types of assessment you can do
Individual: diagnosis, screening, monitoring
Population: policy setting, nutritional surveillance, programme evaluation
body weight =
fat + lean tissue (incl water)
draw BMI chart
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