ANTHROPOMETRIC MEASUREMENTS

Weight lbs ÷ 2.2 kg

Height inches x 2.54 cm
Body Mass Index (BMI) ABW (kg) ÷ Height² (m²) kg/m²
Usual Body Weight lbs ÷ 2.2 kg
Ideal Body Weight (IBW)
Female 100lbs for 5ft + 5 x inches above 5ft lbs
Weight in lbs ÷ 2.2 kg
Male 106lbs for 5ft + 6 x inches above 5ft lbs
Weight in lbs ÷ 2.2 kg
% IBW ( IBW ÷ ABW ) x 100 lbs
Waist Circumference inches x 2.54 cm
Hip Circumference inches x 2.54 cm
Wrist Size cm
Waist to Hip Ratio Waist Circumference ÷ Hip Circumference
cm
Mid Upper Arm Circumference (MUAC) cm
Body Fat Mass % x ABW (lbs) lbs ÷ 2.2 kg
Body Fat Free Mass ABW (lbs) - FM lbs ÷ 2.2 kg
Mid Arm Muscle Circumference (MAMC) MUAC (cm) - [Triceps Skinfold (mm) x 0.314]
cm
Weight Adjustments
Amputation ABW - (% adjustment x ABW) kg
Mild Oedema ABW (kg) - (2-3kg) kg
Demi-Span
Female (16-54 yrs) [1.3 x Demispan (cm)] + 62 cm
Male (16-54 yrs) [1.3 x Demispan (cm)] + 68 cm
Knee Height
Female (18-60 yrs) [1.87 x Knee Height (cm)] + 70.25 cm
Male (18-60 yrs) [1.88 x Knee Height (cm)] + 71.85 cm
Ulna Length cm

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Skinfold Measurements Measurement Site Reading 1 Reading 2 Reading Average
Triceps cm cm cm
Biceps cm cm cm
Subscapular cm cm cm
Suprailiac cm cm cm

ANTHROPOMETRIC INTERPRETATIONS

Body Mass Index (BMI) kg/m²

Interpretation
Ideal Body Weight (IBW) kg
Interpretation

Waist Circumference cm
Interpretation

Wrist Circumference for Frame Size

Interpretation

Mid Upper Arm Circumference (MUAC) cm

Interpretation

Demi-Span
Interpretation

Ulna Length cm
Interpretation

Skinfold Measurements
Interpretation

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 BIOCHEMICAL ASSESSMENT

Test Results Normal Range Nutritional Association

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 NUTRITIONAL INTERVENTION

Nutrient RDA Sources

Vitamin A

Vitamin D

Vitamin E

Vitamin K

Thiamine

Riboflavin

Nicotinamide

Pantothenic Acid

Pyridoxine

Biotin

Folate

Cobalamin

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 NUTRITIONAL INTERVENTION

Nutrient RDA Sources

Ascorbic Acid

Iron

Calcium

Phosphorus

Sodium

Chloride

Potassium

Magnesium

Selenium

Copper

Zinc

Iodine

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 CLINICAL SIGNS & SYMPTOMS

Sign/Symptom Possible Nutrition-Related Causes Possible Non-Nutrition Causes

Hair

Alopecia

Colour changes,
depigmentation

Easily plucked, dull, dry,

lack of shine
Corkscrew hair,
unmerged coiled hairs,
swan neck shape
Flag sign (alternate dark
and light hairs)

Lanugo (very fine, soft

hair)
Eyes
Xanthelasma,
circumferential arcus

Angular blephritis

Pale conjunctiva

Night blindness, dry

membranes, dull/soft
cornea, infected,
ulcerated eye -
Keratomalacia
Angular palpebritis, red/
inflamed conjunctiva
swollen/sticky eyelids
Ring of fine blood vessels
around cornea

Bitot’s spots

Ophthalmoplegia

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 CLINICAL SIGNS & SYMPTOMS

Sign/Symptom Possible Nutrition-Related Causes Possible Non-Nutrition Causes

Face
Skin colour loss, dark
cheeks & under eyes,
Scaling of skin around
nostrils

Pallor

Hyperpigmentation

Enlarged parotid gland

Lips

Soreness, burning, pale

Tongue
Sore, swollen, raw-beefy
red tongue

Sore, burning, purple-ish

Smooth, beefy red tongue

Glossitis

Pale tongue

Gums
Gingivitis, swollen,
spongy, retracting,
bleeding
Taste

Hypogeusia; dysgeusia

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 CLINICAL SIGNS & SYMPTOMS

Sign/Symptom Possible Nutrition-Related Causes Possible Non-Nutrition Causes

Nails

Beau’s lines

Muehrcke’s lines

Koilonychia

Splinter hemorrhage

Brittle, soft, dry, weak or

thin; split easily

Central ridges

Neck
Thyroid enlargement;
goiter
Skin
Slow wound healing,
decubitus ulcers

Acanthosis nigricans

Psoriasis

Eczema

Follicular hyperkeratosis

Seborrheic dermatitis

Petechiae

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 CLINICAL SIGNS & SYMPTOMS

Sign/Symptom Possible Nutrition-Related Causes Possible Non-Nutrition Causes

Skin contd.

Purpura

Xerosis

Perifollicular hemorrhage

Dryness, sandpaper feel,

flakiness

Pellagra

Lack of fat under skin,

cellophane appearance

Bilateral oedema

Yellow pigmentation

Yellow to Orange
pigmentation

Cutaneous flushing

Body oedema, round

swollen face

Pallor, fatigue, depression

Poor skin turgor

Gastrointestinal
Anorexia, flatulence,
diarrhoea

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 CLINICAL SIGNS & SYMPTOMS

Sign/Symptom Possible Nutrition-Related Causes Possible Non-Nutrition Causes

Skeletal System

Bone demineralization

Epiphyseal enlargement
of wrists, legs, knees,
bowed legs, rickets or
osteomalacia, frontal
bossing

Bone tenderness/pain

Muscular System

Weakness

Wasted appearance

Calf tenderness, absent

deep tendon reflexes, foot
and wrist drop
Peripheral neuropathy,
tingling, ‘pins & needles’

Muscle twitching, tetany

Muscle cramps

Muscle pain

Nervous System
Inability to concentrate,
defective memory;
Confabulation;
Disorientation
Peripheral neuropathy
with weakness and
paraesthesias; Ataxia and
decreased tendon
reflexes

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 Dietary Assessment

Have you gained or lost weight in the last 30 days? yes no

Explain, if yes

Gut Health Data

Sign/Symptom Yes Date of onset Sign/Symptom Yes Date of onset
Abdominal Pain Constipation
Epigastric Pain Diarrhoea
Heartburn Alternate loose/solid stool
Regurgitation Steatorrhoea
Bloating Loose Stool
Empty Feeling Early Satiety
Nausea Lethargy
Vomiting Pain when Hungry
Loss of Appetite Postprandial Pain
Belching Fluid Retention
Flatulence Loss of Taste
Haematemesis Mouth Sores
Dysphagia Swollen Tongue
Painful Stool
Allergies
Allergy Yes Description Symptoms
Food
Medication
Supplement
Environment
Supplement (Food/Nutrient)
Supplement Name Dose Reason Frequency

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 Dietary Assessment

Smoking
Yes No Occasional Chain
Fluid Intake
Drink Frequency/day Drink Frequency/day
Water Soda
Coffee Diet Soda
Tea Other
Meal Patterns
Frequency/ week Location of Meal (Home/Outside)
Main Meal Weekend
Snack Weekend
Main Meal Weekdays
Snack Weekdays
Management of Symptoms
Symptom Management

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 Dietary Assessment

24 Hour Recall

Meal Food Eaten Amount/Serving

Breakfast

Lunch

Dinner

Snacks

Nutritional Calculations of Dietary Intake - 24 Hour Recall

Energy Carbohydrates Protein Fats
Group Exchanges Others
(kcal) (g) (g) (g)

Starch

Fruits

Milk & Dairy

Non-Starchy
Vegetables
Meat & Meat
Substitutes

Fats

Miscellaneous

Total

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 Dietary Assessment

Usual Dietary Intake

Meal Food Eaten Amount/Serving

Breakfast

Lunch

Dinner

Snacks

Nutritional Calculations of Dietary Intake - Usual Dietary Intake

Energy Carbohydrates Protein Fats
Group Exchanges Others
(kcal) (g) (g) (g)

Starch

Fruits

Milk & Dairy

Non-Starchy
Vegetables
Meat & Meat
Substitutes

Fats

Miscellaneous

Total

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

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