Week 5: Nutritional Assessment- Anthropometric

Question 1

why is it essential for health professionals to be able to determine the nutritional status of individuals?

Answer 1

continuing presence of nutrition related disease

Question 2

nutritional assessment is essential in determining….?

Answer 2

whether a person is at nutritional risk, what the nutritional problem is, how to best treat it, and monitor person’s response to treatment

Question 3

Which step is nutritional assessment in the nutrition care process?

Answer 3

first step

Question 4

how many steps are in the nutrition care process and what are they?

Answer 4

4- anthropometric, biochemical, clinical, dietary assessment

Question 5

What is NCP?

Answer 5

(nutrition care process)- systematic problem solving method where dietetic practitioners use critical thinking to make evidence based decisions addressing nutrition related problems

Question 6

why was the NCP established?

Answer 6

provide consistent, standardized process for delivery of nutrition related care to patients that’s safe, effective, high quality

Question 7

What does the NCP ensure?

Answer 7

less variation of practice and higher degree of predictability in terms of outcome

Question 8

What are the steps of NCP?

Answer 8

1. Nutrition assessment
2. Nutrition diagnosis
3. Nutrition intervention
4. Nutrition monitoring and evaluation

Question 9

What is NCP centered around? How is it put into practice?

Answer 9

patient/client centered; respectful, empathetic, non judgmental, culturally sensitive, demonstrate good listening skills

Question 10

What does nutrition assessment entail?

Answer 10

-food/nutrition history
- anthropometrics
- biochemical lab data
- physical findings
- client history

Question 11

What does nutrition diagnosis entail?

Answer 11

intake, clinical, behavioral- environmental; write PES

Question 12

What does nutrition Intervention entail?

Answer 12

food/nutrient, nutrition education, counselling, care

Question 13

What does nutrition monitoring & evaluation entail?

Answer 13

determine/measure progress

Question 14

What does PES stand for?

Answer 14

Problem (w/ proper diagnostic term), Etiology (root cause/risk factors), signs and symptoms
- single structured sentence

Question 15

What measures can be obtained from anthropometry?

Answer 15

-health, development, growth in infants/children
- weight, stature, skinfold thickness, circumference, limb lengths, diameters and breadth
- BMI, waist hip ratio

Question 16

How is anthropometry useful?

Answer 16

-used to evaluate nutritional status,
-valuable in monitoring effects of nutritional intervention for disease, trauma, surgery, malnutrition

Question 17

What is the Frankfort horizontal plane?

Answer 17

-position of head where stature/height measured
- represented by line b/w lowest point of orbit of eye and the region

Question 18

How is stature/height measured?

Answer 18

-with subject standing erectly
-used when subject can stand without help
-most children can stand on their own by 2 years old

Question 19

How is (recumbent) length measured?

Answer 19

-measured with subject lying face up
-used when subject cannot stand on their own
- two people are required to measure

Question 20

What is head circumference used for?

Answer 20

used to detect abnormalities in cranial growth and development (children)
- rapid increase in first year; slower after 3 years old

Question 21

What is body weight used for?

Answer 21

• one of most important measurements in nutritional assessment
• used in equations predicting caloric expenditure & indices of body composition

Question 22

Define non-ambulatory person

Answer 22

persons who cannot stand unassisted on a scale- weighed in bed/wheelchair scale

Question 23

What is an alternative way to compute body weight for non-ambulatory persons?

Answer 23

knee height, calf circumference, midarm circumference, subscapular skinfold thickness

Question 24

What are CDC growth charts used for? What is it based on?

Answer 24

assess growth and development of infants, children, adolescents
- based on growth data from large numbers of healthy “” “”

Question 25

What is an important advancement developed by CDC growth charts?

Answer 25

BMI for age growth charts

Question 26

How to plot data on growth chart?

Answer 26

1.locate subject's age on x axis 2.locate subject's length, weight, head circum. on y axis 3. Draw small circle on chart where lines of two values intersect

Question 27

What is considered the average/median value for specific population of interest?

Answer 27

the 50th percentile

Question 28

Define overweight

Answer 28

body weight in excess of some reference point - reference point usually defined in terms of weight for height

Question 29

Define obesity

Answer 29

excess amount of body fat relative to lean body mass- expressed as % for adipose tissue - BMI recommended clinical approach for evaluation height relative to height

Question 30

Define BMI, how is it calculated? What is it also known as?

Answer 30

- body mass index; strong relationship to disease and mortality risk - weight in kg divided by height in meters squared - Quetelet's index

Question 31

What are the cons of using BMI?

Answer 31

- overestimates body fat in people who are very muscular/ have edema - underestimates body fat in those who have lost lean body mass such as elderly and frail

Question 32

What is considered underweight and healthy weight according to the BMI?

Answer 32

underweight: <18.5 kg/m2 healthy weight: 18.5-24.9 kg/m2

Question 33

What is considered overweight and obese according to the BMI?

Answer 33

overweight: 25.0-29.9 kg/m2 obese: >= 30 kg/m2

Question 34

What does frame size measurement include?

Answer 34

- biacromial breadth - bitrochanteric breadth -ratio of stature to wrist circumference - breadth of chest from chest x rays - knee and wrist breadth - elbow breadth

Question 35

What are the two classifications for body fat distribution?

Answer 35

1. upper body, android, male type (disease risk increased in persons w/ android obesity) 2. lower body, gynoid, female type

Question 36

What is the recommended approach for assessing total abdominal fat?

Answer 36

waist circumference, easy to perform in clinical setting

Question 37

What is body composition?

Answer 37

ratio of fat to fat-free mass and expressed as percentage of body fat

Question 38

What is the 2-compartment model?

Answer 38

body divided into fat mass and fat free mass (muscle, water, bone, and other tissues devoid of fat and lipid)

Question 39

What is the 4-compartment model?

Answer 39

human body composed of four chemical groups: water, protein, mineral, fat

Question 40

What are the different kinds of body composition methods?

Answer 40

skinfold measurements, underwatering weighing, air-displacement plethysmography, bioelectrical impedance analysis

Question 41

What is the most widely used method to estimate percent body fat in clinical settings?

Answer 41

skinfold measurements

Question 42

What are the advantages of using skinfold measurements?

Answer 42

equipment is inexpensive, portable, requires little space

Question 43

What is required for multiple site skinfold measurements?

Answer 43

estimating equations- developed by comparing variety of skinfold and other anthropometric measures with measurements of body density or body fat % to see which anthropometric measures fit best

Question 44

What is densitometry? How is it expressed?

Answer 44

-assessing body composition by measuring density of entire body - expressed as mass/unit volume

Question 45

How is density usually obtained?

Answer 45

-hydrostatic/ underwater weighing - air displacement plethysmography - DXA (dual energy X-ray absorptiometry)

Question 46

What is the BOD POD? What are its advantages?

Answer 46

body comp. instrument- air displacement plethysmograph - highly accurate, safe, comfortable, fast results

Question 47

What is the PEA BOD?

Answer 47

air displacement plethysmography (ADP) using whole body densitometry; used for infants b/w 1-8 kg.

Question 48

What is bioelectrical impedance?

Answer 48

electrical current passes through fat-free mass body compartments with high amounts of electrolyte-rich water where resistance is lowest.

Question 49

What is required for bioelectrical impedance (BIA) to be successful?

Answer 49

must ensure that individual is in state of normal hydration

Question 50

What is DXA?

Answer 50

Dual-energy X-ray absorptiometry -measure body composition & bone mineral density -convenient, quick, accurate, precise, safe, low radiation dose - assess fat and fat free soft tissue

Question 51

Impedance to electric current is greatest in...?

Answer 51

fat tissue (14-22% water content)

Question 52

What are the strengths of DXA?

Answer 52

-non invasive -easy, quick -cheap, simple equipment - intensive training not needed -measurements can be compared to reference values by age and sex

Question 53

What are the weaknesses of DXA?

Answer 53

- cannot identify deficiencies -can't detect small changes in nutrition status/body fat to lean mass -single measurements cannot assess growth/ body composition to indicate nutrition status

Question 54

What is the fundamental principle of DXA?

Answer 54

measurement of the transmission of X rays through the body at high and low energies