Nutritional Status Assessment

Question 1

Why We Need Nutritional
Status Assessment?

Answer 1

Identify individuals or population groups at risk of becoming malnourished

Question 2

Nutritional Status Assessment

Answer 2

Anthropometry
Biochemical
Clinical
Dietary assessment

Question 3

Anthropometric Methods

Answer 3

The measurement of body height, weight &
proportions

Question 4

Anthropometric Method values reflects the

Answer 4

current nutritional status & do not differentiate between acute & chronic changes

Question 5

Other anthropometric
Measurements

Answer 5

Mid-arm circumference
Skin fold thickness
Head circumference
Head/chest ratio
Hip/waist ratio

Question 6

Nutritional Indices in Adults

Answer 6

BMI = Weight (kg)/Height (m²)
Higher BMI (obesity level) is associated with Type 2 DM & high risk of cardiovascular morbidity & mortality

Question 7

Waist circumference

Answer 7

Predicts mortality better than any other anthropometric measurement.

Question 8

Waist circumference Level 1

Answer 8

is the maximum acceptable waist
circumference irrespective of the adult age and
there should be no further weight gain

Question 9

Waist circumference Level 2

Answer 9

denotes obesity and requires weight
management to reduce the risk of type 2 DM &
cardiovascular complications

Question 10

Interpretation of WHR

Answer 10

High risk WHR= > 0.80 for females & >0.95 for males

Question 11

Visceral Abdominal Fat

Answer 11

Fat mainly around the waist is more likely to
develop health problems than fat mainly in hips and thigh

Question 12

Body Composition ( Body Mass)

Answer 12

 LBM – Body mass that contains small % (~3%)
essential fat [Essential fat + Muscle + Water + Bone]
 Fat Free Mass (FFM)

Question 13

Body Composition (Fat Store)

Answer 13

Essential Fat for physiological function, eg.
fat stored in muscle, liver, heart
 Storage fat
in adipose tissue – visceral fat and
subcutaneous fat

Question 14

Albumin

Answer 14

Not a good indicator of protein status during critical illness (due to acute phase response)

Question 15

Factors Affecting Serum Albumin
Levels

Answer 15

Increased in:
Dehydration, blood transfusions (exogenous albumin)
Decreased in:
Over-hydration, hepatic failure, inflammation, infection, metabolic stress, post-op, bed rest, pregnancy, nephrotic syndrome

Question 16

Transferrin

Answer 16

Half life 8-10 days
Involved with iron transport, influenced by iron status

Question 17

Retinol Binding Protein (RBP)

Answer 17

Half life 12 hours
Affected by renal function, Vitamin A and Zn status

Question 18

Advantages

Answer 18

-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

Question 19

Clinical Assessment

Answer 19

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

Question 20

DIETARY ASSESSMENT

Answer 20

24 hours dietary recall
Food frequency questionnaire
Dietary record
Observed food consumption

Question 21

24 Hours Dietary Recall

Answer 21

-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

Question 22

Food Frequency Questionnaire

Answer 22

-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

Question 23

Limitations: Food Frequency Questionnaire

Answer 23

 long Questionnaire
 Errors with estimating serving size
 Needs updating with new commercial food products to keep pace with changing dietary habits

Question 24

DIETARY RECORD

Answer 24

-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

Question 25

Observed Food Consumption

Answer 25

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