Nutritional Status Assessment Flashcards
Why We Need Nutritional
Status Assessment?
Identify individuals or population groups at risk of becoming malnourished
Nutritional Status Assessment
Anthropometry
Biochemical
Clinical
Dietary assessment
Anthropometric Methods
The measurement of body height, weight &
proportions
Anthropometric Method values reflects the
current nutritional status & do not differentiate between acute & chronic changes
Other anthropometric
Measurements
Mid-arm circumference
Skin fold thickness
Head circumference
Head/chest ratio
Hip/waist ratio
Nutritional Indices in Adults
BMI = Weight (kg)/Height (m²)
Higher BMI (obesity level) is associated with Type 2 DM & high risk of cardiovascular morbidity & mortality
Waist circumference
Predicts mortality better than any other anthropometric measurement.
Waist circumference Level 1
is the maximum acceptable waist
circumference irrespective of the adult age and
there should be no further weight gain
Waist circumference Level 2
denotes obesity and requires weight
management to reduce the risk of type 2 DM &
cardiovascular complications
Interpretation of WHR
High risk WHR= > 0.80 for females & >0.95 for males
Visceral Abdominal Fat
Fat mainly around the waist is more likely to
develop health problems than fat mainly in hips and thigh
Body Composition ( Body Mass)
LBM – Body mass that contains small % (~3%)
essential fat [Essential fat + Muscle + Water + Bone]
Fat Free Mass (FFM)
Body Composition (Fat Store)
Essential Fat for physiological function, eg.
fat stored in muscle, liver, heart
Storage fat
in adipose tissue – visceral fat and
subcutaneous fat
Albumin
Not a good indicator of protein status during critical illness (due to acute phase response)
Factors Affecting Serum Albumin
Levels
Increased in:
Dehydration, blood transfusions (exogenous albumin)
Decreased in:
Over-hydration, hepatic failure, inflammation, infection, metabolic stress, post-op, bed rest, pregnancy, nephrotic syndrome
Transferrin
Half life 8-10 days
Involved with iron transport, influenced by iron status
Retinol Binding Protein (RBP)
Half life 12 hours
Affected by renal function, Vitamin A and Zn status
Advantages
-Useful in detecting early changes in body
metabolism & nutrition before the appearance of overt clinical signs
-Precise, accurate and reproducible
-Useful to validate data obtained from dietary
methods e.g. comparing salt intake with 24-hour urinary excretion
Clinical Assessment
Medical history, treatment and medications
Significant factors affecting nutritional intake
Fluid balance – input and output, bowel habits
Physical assessment of nutritional status
Clinical signs and symptoms
DIETARY ASSESSMENT
24 hours dietary recall
Food frequency questionnaire
Dietary record
Observed food consumption
24 Hours Dietary Recall
-A trained interviewer asks the subject to recall all food & drink taken in the previous 24 hours
-It is quick, easy, & depends on short-term memory, but may not be truly representative of the person’s usual intake
Food Frequency Questionnaire
-In this method the subject is given a list of around 100 food items to indicate his or her intake (frequency & quantity) per day, per week & per month
-Inexpensive, more representative & easy to use
Limitations: Food Frequency Questionnaire
long Questionnaire
Errors with estimating serving size
Needs updating with new commercial food products to keep pace with changing dietary habits
DIETARY RECORD
-It is an accurate method for assessing the nutritional status
-The information should be collected by a trained interviewer
-Details about usual intake, types, amount, frequency & timing needs to be obtained
-Cross-checking to verify data is important
Observed Food Consumption
1.The most unused method in clinical practice, but it is recommended for research purpose
2. The meal eaten by the individual is weighed and contents are exactly calculated
3. The method is characterized by having a high degree of accuracy
but expensive & needs time & effort
