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Nutritional Assessment Lecture

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Faisal Ali
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33 views

Nutritional Assessment Lecture

Uploaded by

Faisal Ali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Assessment of Nutritional and

Health status

Assoc.Prof.dr.faisal
Outlines
 Nutritional status
 Importance of Nutritional status
 Health status or medical history information
 Methods of nutritional assessment
 Nutritional diagnosis
 Clinical signs of nutritional deficiencies
 Evaluation of nutritional data
Learning objectives

 By the end of this lecture the student should be


able:

 To know the different methods for assessing the


nutritional status.

 To understand the basic anthropometric


techniques, applications & reference standards.
Introduction
 The nutritional status of an individual is often the
result of many related factors.

 It is influenced by food intake, quantity & quality,


& physical health.

 The spectrum of nutritional status spread from


normal-nutrition, over-nutrition to malnutrition.
What is nutritional status?

Is the current body status of a person or a group of


populations related to their state of nourishment (the
consumption and utilization of nutrients).

The nutritional staus is determined by a complex interaction


between internal and external factors:
Internal factors (e.g., age, sex,diseases,behaviour).
External factors: (e.g., physical activity,diet, socioeconomic
state, safety factor).
Nutritional Assessment… Why?

 The purpose of nutritional assessment is:

 To determine nutritional problems & thus develop


proper nutrition care.

 To achieve or maintain good nutritional status.

Identify individual or population groups


at risk or warning signs of becoming malnourished.
Health status prior nutrition status
 Health History (medical history) - current and past
health status.

 Diseases/ risk factors for disease.


 Appetite/food intake.
 Drug medications use
 Conditions affecting digestion, absorption, metabolism,
utilization, & excretion of nutrients.
 Physical and mental health.
Nutritional status team
 Physician

 Registered Dietitian

 Nursing Assistant

 Pharmacist

 Social Worker
Methods of Nutritional assessment
 These are summarized as ABCD:

 A = ANTHROPOMETRIC MEASURMENT
 B = BIOCHEMICAL ANALYSIS
 C = CLINICAL ASSESSMENT
 D = DIETARY INTAKE INFORMATION
 E = EVALUATION OF DATA
Anthropometric Methods
 Anthropometry is the measurement of body height,
weight.

 It is used to evaluate both under & over nutrition.

 The measured values reflects the current


nutritional status.
ANTHROPOMETRIC MEASURE

 The international standard for assessing body


size in adults is the body mass index (BMI).

 BMI is computed using the following formula:


BMI = Weight (kg)/ Height (m²).

 Evidence shows that high BMI (obesity level) is


associated with type 2 diabetes & high risk of
cardiovascular morbidity & mortality.
BMI (WHO - Classification)
Anthropometry for children

 Accurate measurement of height and weight is


essential. The results can then be used to
evaluate the physical growth of the child.

 For growth monitoring the data are plotted on


growth charts over a period of time that is
enough to calculate growth velocity, which can
then be compared to international standards.
Other anthropometric Measurements

 Mid-arm circumference-muscle mass


 Skin fold thickness-total subcutaneous fat
 Waist circumference-fat mass
 Hip circumference
 Hip/waist ratio
Biochemical analysis
 Hemoglobin estimation is the most important test, &
useful index of the overall state of nutrition. Beside
anemia it also tells about protein & trace element
nutrition.
 Stool examination for the presence of ova and/or
intestinal parasites.
 Blood exam: iron, vitamins (D,B12,folic acids),
albumin, sugar and creatinine..
 Minerals: Na, K, calcium, magnesium , Phosphorus.
CLINICAL ASSESSMENT

 It is the simplest & most practical method


of ascertaining the nutritional status.

 It utilizes a number of physical signs, that


are known to be associated malnutrition
and deficiency of micronutrients.
CLINICAL ASSESSMENT
 Look at the patient:
 Observe physical signs and symptoms of Nutritional
deficiencies:
 Pallor Skin- anemia (Iron,B12 and folic acid deficiency
 Hair – protein energy malnutrition
 Eyes – hyperlipidemia, vitamins deficiency
 Mouth – vitamins deficiency
 Nails – protein and iron deficiency
 Goiter- iodine deficiency
DIETARY ASSESSMENT

 Nutritional intake of humans is assessed


by different methods, such as:

 24 hours dietary recall (24HR)


 Food Frequency Questionnaire (FFQ)
 Dietary Record (DR)
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 (type, frequency & quantity) per
day, per week & per month.

 inexpensive, more representative & easy


to use.
Interpretation of Dietary Data

 Qualitative Method:

 Using the food pyramid & dietary guidelines.

 Different nutrients are classified into 5 groups (fat & oils,


bread & cereals, milk products, meat-fish-poultry,
vegetables & fruits)

 Determine the number of serving from each group &


compare it with minimum requirement.
Interpretation of Dietary Data

 Quantitative method:

 The amount of energy & specific nutrients


in each food consumed can be calculated
using food composition tables or nutrition
software & then compare it with the
recommended daily intake.
Evaluation
 Evaluate nutritional status data and develop :

1. Nutrition care plan, if necessary, to meet patient’s nutrient and education needs.

2. Medical nutrition and/or drug therapy.

3. Evaluate effectiveness of care plan: ongoing follow-up, reassessment, and modification of care
plan.

 4. Implement: Implement care plan

 5. Evaluate:
Take home questions ??
 What is nutritional status?

 Why does nutritional assessment


important?

 What are the methods of assessment?


References

 Clinical Nutrition in practice 2010


Blackwell Publishing Ltd.

 Understanding of clinical nutrition PDF.

 Websites.
Thank you !!

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