Nutritional assessment part 1 Flashcards
What are the components of nutritional assessment
Anthropometry + body composition
Biochemical
Clinical
Dietary
Enviromental
Functional
Nutritional status
the condition of the body’s nutrient stores as a result of the intake, absorption, and metabolism of energy and nutrients, and the influence of physiological needs and disease-related factors
Nutritional risk
nutrition related problems
Screening
process of indentifying chracteristics known to be associated with nutritional problems
Assessment
a systematic method for obtaining, verifying and interpreting data needed to determine nutritional status, nutrion-related problems, their causes and signifiance
Nutritional screening - components
- involuntary weight loss
- dietary intake (if they loss the appetite)
- pre-existing condition causing nutrient loss (diarrhea, malabsorption)
- conditions that increase nutrient requirement (inflammation fever, burn, injury)
Goals for nutritional assessment
- indentify needing nutritonal support
- to use as a baseline for monitoring and evaluating the response to our nutritional intervention plan
for : disease prevention and management, identify specific deficiencies and or overall malnutriton
why do we assess?
malnutriton is associated with increases : morbodity, mortality, hospital lenght of stay, use of health care and cost
how much malnutriton affects the hospitalized patients
50%
Evaluation/ interpretation of assessment
clinical data ( physical signs and changes)
dietary data (DRIs, Canadian Food Guide, and USDA food pyramid)
functional data
subjetcive vs objective data
In a development of nutritional deficiency, how many stages there are? what are the first and last ones
there are 8 stages.
The first is dietary inadequacy, decrease of tissue and the last ones are clinical symptoms and anatomical signs
What anthropometry means
measurement of body size, weight and proportions
what are the 2 parts of body composition
fat
fat free mass
with what object do we measure height standing
standiometer
if a person is unable to stand how do we measure its height
knee height in their bed (90 degrees)
There is also arm span
body weight
- sum of all components at each level of body composition
- using standing, chair or bed scales
- min clothes and no shoes
- timing and hydration changes
- body weight does not mean body composition
- consider amputation
BMI
equation
BMI = weight (kg)/ height^2 (m^2)
BMI SCALES
- underweight
healthy
overweight
obesity 1
obesity 2
obesity 3
<18.5 under
18.5-24.9 healthy
25-29.9 overweight
30-34.9 obesity 1
35-39.9 obesity 2
>40 obesity 3
For older people the BMI changes. What is their healthy BMI
24-29
What is the limitation of the BMI
don’t measure the body composition
varies in relation to age sex and ethnicity
limited applicability in athletes
must be accompanied by another measure (waist circumference)
Weight assessment: % usual body weight (UBW)
equation
%UBW = (current weight/usual weight BW) x 100
weight assessment : % weight change
% change = (UBW - current weight )/ UBW x 100
What is a significance loss and a severe loss of weight in % in a time interval of 3 months and 6 months
3 months: 7.5% (significant loss) and >7.5% (severe loss)
6 months 10% (significant) and >10% (severe)
Involuntary weight loss means
loss of fat and fat-free mass and it can predict mortality, malnutriton etx
Skinfold thickness indicates
subcutaneous adipose tissue. It is used in the biceps, triceps, subscapular, suprailiac
Body circumferences and areas
- MAC : Mid-upper arm circonference
- MAMC : mid-upper arm muscle circumference
MAMA: mid-upper arm mucle area
cMAMA : corrected mid-upper arm muscle area
MAFA: mid-upper arm fat area
MAC : reflects muscle, bone, and subcutaneous fat not sensitive to muscle changes
MAMC: corrects subcutaneous fat
MAMA : reflects total body muscle mass, but insensitive to small changes in muscle. Less valid in elderly or obese than younger and healthier weight
cMAMA :only muscle no bone
Mafa : reflects sub-cutaneous adipose tissue stores. A better indicator of total body fat than a single skinfold measurement
Body circumference and areas of MAMA and MAFA, what are the percentile rank for muscle/fat deficit, below average,average and above average
MAMA AND MAFA
< 5 - deficit
5.1-15 below average
15.1-85 : average
>85 : above average
waist circumferences
reflects abdominal subcutaneous and visceral fat stores. Measures circumference.
more than 102 cm in men and more than 88 cm in = abdominal obesity women
true or false
high BMI and low waist circumference - low risk for cardiovascular disease
true
waist : hip ratio
estimates distribution of abdominal adipose and muscle tissue
Bioelectrical impedance
low electrical charge that goes in your body and estimated fat mass, fat free mass and total body water.
It is rapid and non invasive
what is the limitation of bioelectrical impedance
- influenced by hydration status
- less precise in atypical bodies
Dual energy X-ray absorptiometry
Imaging technique, based on attenuation of radiation from diff tissue densities. It will measure bone, soft lean and fat tissues.
good for bone density
what is the limitation of dual energy X-ray absorptiometry
expensive
min exposure to radiation
assumes normal hydration status.
Air displacement (BOD POD)
total body volume measured by air displacement in a chamber. Based on fat and lean tissue density
Limitation of air displacement
access to instruments,
expensive
residua lung volume must be measured
