14 nutrition assessment


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14 nutrition assessment

  1. 1. 14—Nutrition assessment Nutrition and Fitness Dr. Siham Gritly
  2. 2. Nutritional assessment• nutrition assessment: a comprehensive analysis of a person’s nutrition status that uses health, socioeconomic, drug, and diet histories; anthropometric measurements; physical examinations; and laboratory tests. Dr. Siham Gritly
  3. 3. Types of nutritional deficiency• malnutrition: any condition caused by excess or deficient food energy or nutrient intake or by an imbalance of nutrients.• Under-nutrition: deficient energy or nutrients.• Over-nutrition: excess energy or nutrients. Dr. Siham Gritly
  4. 4. The severe wasting characteristic of marasmusAdapted from Ellie Whitney and Sharon Rady Rolfes; Under standingNutrition, Twelfth Edition. 2011 Dr. Siham Gritly
  5. 5. The edema characteristic of kwashiorkor is apparentin this child’s swollen belly. Malnourishedchildren commonly have an enlarged abdomen from parasitesas well. Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standingNutrition, Twelfth Edition. 2011 Dr. Siham Gritly
  6. 6. Obese childrenover nutrition Dr. Siham Gritly
  7. 7. Stages in the Development of a Nutrient Deficiency• 1-Primary deficiency caused by inadequate diet or Secondary deficiency caused by problem inside the body------assessment methods;-Diet history and Health history• 2-Declining nutrient stores (subclinical) and Abnormal functions inside the body assessment methods;-Laboratory tests Dr. Siham Gritly
  8. 8. • 3-Physical signs and symptoms, assessment methods; -Physical examination and anthropometric measures Dr. Siham Gritly
  9. 9. Nutrition Assessment of Individuals• Nutrition Assessment of Individuals, can be achieved by a registered dietitian; dietetic technician, or other trained health-care professional uses:• 1- Historical information• 2- Anthropometric measurements• 3- Physical examinations• 4- Laboratory tests Dr. Siham Gritly
  10. 10. 1-Historical information• One step in evaluating nutrition status is to obtain information about a person’s;• health status,• Socio-economic status,• A diet history, drug use.• The health history• family history• Social factors, ethnic background,• educational level Dr. Siham Gritly
  11. 11. Historical Data Used in Nutrition Assessments Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition. 2011Type of History What It IdentifiesHealth history Current and previous health problems and family health history that affect nutrient needs, nutrition status, or the need for intervention to prevent or alleviate health problemsSocioeconomic history Personal, cultural, financial, and environmental influences on food intake, nutrient needs, and diet therapy optionsDrug history Medications (prescription and over-the-counter), illegal drugs, dietary supplements, and alternative therapies that affect nutrition statusDiet history Nutrient intake excesses or deficiencies and reasons for imbalances Dr. Siham Gritly
  12. 12. Diet history• food record: an extensive, accurate record of all foods eaten over a period of several days or weeks. A food record that includes associated information such as when, where, and with whom each food is eaten is sometimes called a food diary. Dr. Siham Gritly
  13. 13. • The data may be collected by recording the foods the person has eaten over a period of 24 hours, 3 days, or a week or more or by asking what foods the person typically eats and how much of each.• food frequency questionnaire: a checklist of foods on which a person can record the frequency with which he or she eats each food. Dr. Siham Gritly
  14. 14. 2- Anthropometric measurements• anthropometric measurements such as those of height and weight skin fold thickness• provide little information about specific nutrients. Instead, measurements may reveal problems such as growth failure in children wasting or swelling of body tissues in adults, and obesity. Dr. Siham Gritly
  15. 15. Anthropometric Measurements Used in Nutrition Assessments Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition. 2011Type of Measurement What It ReflectsAbdominal girth measurement Abdominal fluid retention and abdominal organ sizeHeight-weight Over-nutrition and under-nutrition; growth in childrenHead circumference Brain growth and development in infants and children under age 2Skin-fold Subcutaneous and total body fatWaist circumference Body fat distribution Dr. Siham Gritly
  16. 16. Skin-fold thicknessusing Calipers• Skin-fold measures• estimate body fat by using a caliper to measure the thickness of a fold of skin on the back of the arm (over the triceps), below the shoulder blade (subscapular), and in other places (including lower-body sites), and then comparing these measurements with standards Dr. Siham Gritly
  17. 17. Waist or Abdominal Girth (circumference)• the purpose of determining waist girth is to gain a measure of the amount of abdominal fat (visceral fat), which has been linked to increased risk of coronary heart disease and diabetes.• The waist measurement is taken by a tape at the narrowest waist level, or if this is not apparent, at the mid point between the lowest rib and the top of the hip bone (illiac crest). Dr. Siham Gritly
  18. 18. Waist or Abdominal Girth values Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition. 2011 Men WomenRisk cm inches cm inchesVery High > 120 > 47 > 110 43.5High 100 - 120 39.5 - 47 90 - 109 35.5 – 43Low 80 - 99 31.5 - 39 70 - 89 28.5 – 35Very Low < 80 < 31.5 < 70 < 28.5 Dr. Siham Gritly
  19. 19. Waist–hip ratio• Waist–hip ratio or waist-to-hip ratio (WHR) is the ratio of the circumference of the waist to that of the hips.• Waist/hips• WHR is used as a measurement of obesity, Dr. Siham Gritly
  20. 20. The Waist to Hip Ratio Calculator indicates yourprobable health risks. People with more weight aroundthe waist, face more health risks than people who carrymore weight around their hips Health Risk BasedMale Female Solely on WHR0.95 or below 0.80 or below Low Risk0.96 to 1.0 0.81 to 0.85 Moderate Risk1.0+ 0.85+ High Risk Dr. Siham Gritly
  21. 21. • Waist/hip ratio - divide the waist circumference by the hip circumference. Above 0.95 for men (or 0.8 in women) indicative of a health risk• WHO states that abdominal obesity is defined as a waist–hip ratio above 0.90 for males and above 0.85 for females, or a body mass index (BMI) above 30.0 Dr. Siham Gritly
  22. 22. 3- Physical examinations• A third nutrition assessment technique is a physical examination looking for clues to poor nutrition status. Dr. Siham Gritly
  23. 23. Physical Findings Used in Nutrition Assessments 1 Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing . Nutrition, Twelfth Edition 2011Body System Healthy Findings Malnutrition Findings What the Findings Refl ectHair Shiny, firm in the scalp Dull, brittle, dry, loose; PEM falls outEyes Bright, clear pink membranes Pale membranes; spots; Vitamin A, B adjust easily to light redness adjust slowly to vitamin, zinc, darkness and ironTeeth and No pain or caries, gums firm Missing, discolored, Mineral andgums teeth bright decayed teeth; gums vitamin C bleed easily and are status swollen and spongyGlands No lumps Swollen at front of neck PEM and iodine statusTongue Red, bumpy, rough Sore, smooth, purplish, B vitamin swollen Dr. Siham Gritly status
  24. 24. Physical Findings Used in Nutrition Assessments 2Skin Smooth, firm, good Off-color, scaly, fl aky, cracked, PEM, color dry rough, spotty; “sandpaper” essential fatty feel orsores; lack of fat under acid, vitamin skin A, B vitamin, and vitamin C statusNails Firm, pink Spoon-shaped, brittle, ridged, pale Iron statusInternal Regular heart rhythm, heart Abnormal heart rate, heart rhythm, o PEM and mineralsystems rate, and blood pressure; no rblood pressure; enlarged liver, splee status impairment of digestive nabnormal digestion; burning, tingling of function, reflexes, or mental hands, feet; loss of balance, coordination, status mental confusion, irritability, fatigueMuscles and Muscle tone; posture, long “Wasted” appearance of muscles swollen PEM, mineral, andbones bone development bumps on skull or ends of bones; small vitamin D status appropriate for age bumps on ribs; bowed legs or knock- knees Dr. Siham Gritly
  25. 25. 4- Laboratory tests• A fourth way to detect a developing deficiency, imbalance, or toxicity is to take samples of blood or urine, analyze them in the laboratory, and compare the results with normal values for a similar population.• Laboratory tests are most useful in uncovering early signs of malnutrition before symptoms appear. Dr. Siham Gritly
  26. 26. Nutrition Assessment of Populations• Nutrition Assessment of Populations is to assess a population’s nutrition status,• The data collected are then used by various agencies for numerous purposes, including the development of national health goals. Dr. Siham Gritly
  27. 27. • National Nutrition Surveys• The National Nutrition Monitoring program coordinates the many nutrition-related surveys and research activities of various federal agencies.• Surveys provide valuable information about the kinds of foods people eat• Then researchers calculate the energy and nutrients in the foods and compare the amounts consumed with a standard. Dr. Siham Gritly
  28. 28. • The other survey examines the people themselves, using;• * anthropometric measurements,• * physical examinations,• * laboratory tests.• The data provide valuable information on several nutrition-related conditions such as growth retardation, heart disease, and nutrient deficiencies Dr. Siham Gritly
  29. 29. • National nutrition surveys often oversample high-risk groups;• *low-income families,• * pregnant women,• *adolescents,• * elderly, Dr. Siham Gritly
  30. 30. references• Sareen S. Gropper, Jack L.Smithh and James L. Groff; 2007. advanced Nutrition and Human Metabolism, fifth ed. Wadsworth CENGAGE learning• Brodie, D. A. (1988). Techniques of measurement of body composition Part II. Sports Medicine, 5, 74-98. Heyward, V. H. (1991). Advanced fitness assessment & exercise prescription. Champaign: Human Kinetics Publishers. Jackson, A.S. & Pollock, M.L. (1985) Practical assessment of body composition. The Physician and Sportsmedicine, 13, 5, 76-90• Melvin H Williams 2010; Nutrition for Health, Fitness and Sport. 9th ed, McGraw Hill• World Health Organization Report (WHO 1987)• Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition. 2011, 2008 Wadsworth, Cengage Learning Dr. Siham Gritly