Nutrition Research's

1. NUTRITION ASSESSMENT &
NUTRIGENOMICS
CODE: 357FP63

2. INTRODUCTION
Nutrition is the science of food and its
relationship to health
It is a biochemical and physiological process by
which an organism uses food to support its life.
Food that is consumed tend to have effects on
the body in different ways.

3. INTRODUCTION II
Nutrigenomics is the study of the effects of food
and food constituents on gene expression, and
how genetic variations affect the nutritional
environment
Food includes solids, semisolids and liquids
which can be consumed to keep us healthy.

4. INTRODUCTION III
Food refers to anything which nourishes the body.
Food helps us in the production of heat and energy
for our daily activities.
It helps us in the growth, repair and maintenance of
our body tissues.

5. INTRODUCTION IV
Food provides organisms with nutrients, which can
be metabolized to create energy and chemical
structures.
Failure to obtain sufficient nutrients
causes malnutrition.

6. INTRODUCTION V
•Nutrigenomics is broadly defined as the
relationship between nutrients, diet, and gene
expression
•In addition to the effect of genes on the
phenotype (i.e. the physical expression of genetic
traits), genes can also respond to environmental
influences – of which nutrition is one such
influence.

7. INTRODUCTION VI
•These nutrients include those involved in the one-
carbon cycle such as folate, vitamins B2, B6 and
B12, and others such as vitamin A, which
regulates gene expression.
•More general dietary patterns such as diets with a
high Glycaemic Index (GI) load have also
been associated with insulin resistance and
diabetes type II.

8. STEPS
The following processes are involved in the
utilization of food in the body.
1) Ingestion: It implies intake of food (by
mouth)
2) Digestion: After ingestion food is digested to
make it absorbable. It is achieved by
enzymes present in our mouth (saliva),
stomach and intestines.

9. STEPS 2
3) Absorption: Digested food get absorbed and passes
from our intestines into the blood circulation and
lymphatic system for distribution all over the body.
4) Metabolism of food is the set of life sustaining
chemical changes which undertake within the cells of
living organisms and its utilization for the purpose of
providing fuel to run the cellular processes.

10. NOURISHMENT: What is nourishment?

11. Measuring nourishment?
•Nutritional assessment is used to determine
whether a person or group of people is well
nourished or malnourished (over-nourished or
under-nourished).
•It involves the interpretation of anthropometric,
biochemical (laboratory), clinical and/or dietary
data.

12. COURSE OUTLINE

13. UNIT I
Assessment of Nutritional Status and Surveillance:

14. WHAT IS NUTRITIONAL STATUS?
The nutritional status of an individual:
 is a balance between the intake of the nutrients and
the expenditure of these in processes of growth,
reproduction and health maintenance.
is influenced by food intake , quantity , quality and
physical health.

15. Nutrition Assessment In Detail
Nutritional assessment is the systematic
process of collecting and interpreting
information in order to make decisions about
the nature and cause of nutrition status.

16. 16
Process of Nutritional Assessment

17. Benefits of Nutritional Assessment
17

18. Why Nutritional Assessment?
 To obtain precise information on prevalence and
geographic distribution of nutritional problems of
given community.
o To identify individuals or populations -who are
at risk of becoming malnourished & - who are
already malnourished
o To develop health-care programs.
o To measure the effectiveness of nutritional
programs and interventions once initiated.

19. METHODS OF NUTRITIONAL ASSESSMENT
 Direct methods: – deal with the individuals and
measure the objective criteria
 Indirect methods: – use community health indices
that reflect nutritional influences

20. 1. Direct methods of nutritional status assessment
 These can be summarized as ABCD
 Anthropometric methods
 Biochemical, laboratory methods
 Clinical methods
 Dietary evaluation methods

21. 2. Indirect methods of Nutritional Assessment
These include three categories
 Ecological variables
 Economic factors
 Vital health statistics

22. Direct methods A. Anthropometric methods
 Anthropometry is the measurement of
• Height
• Weight & other measurements like
• Mid Upper-arm circumference
• Skin fold thickness
• Head and chest circumference
• Hip/waist ratio

23. Height measurement
• The subject stand erect on stadiometer
• The movable head piece is leveled with head
vault
• Height is recorded to nearest 0.5 cm.
• For infants infantometer is used.

24.  Anthropometric measurements are noninvasive
quantitative measurements of the body.
 Anthropometry provides a valuable assessment of
nutritional status in children and adults.
 Typically they are used in the pediatric population
to evaluate the general health status, nutritional
adequacy, and the growth and developmental
pattern of the child.

25.  Growth measurements and normal growth
patterns are the gold standards by which
clinicians assess the health and well-being of a
child.
 In adults, body measurements can help to assess
health and dietary status and future disease risk.
 These measurements can also be used to
determine body composition in adults to help
determine underlying nutritional status and
diagnose obesity.

28. • Growth monitoring of a child by comparing
with international / national standards using
growth charts over a period of time.
Anthropometric methods

29. • Can be used to assess infants, children,
pregnant women and adults.
• Uses a regularly calibrated electronic or
balanced-beam scale.
• Measured in light clothes nearest to 100g.
Weight measurement

30. Mid Upper-arm Circumference
• Circumference left upper arm at mid point between
acromion process and olecranon process
• Fiber-glass tape which does not stretch

31. Skin-fold thickness
• skin fold calipers are used (Harpenden and
Lange) measures the thickness of the skin and
subcutaneous fat using constant pressure
applied over a known area
• Common sites: triceps and in the sub-scapular
region
• It has value in assessing the amount of fat and
therefore the reserve of energy in the body

33. Waist/hip ratio
• Waist measurement
• Measured at the level of umbilicus nearest to
0.5cm
• Subject stands erect with relaxed abdominal
muscles, arms at the side and feet together
• Measurement taken at the normal expiration

34. Hip measurement
• Measured at the point of greatest circumference
around hips to nearest 0.5cm Close contact
with the skin without indenting the soft-tissues
• Subject should be standing and measurer beside
him.
• Interpretation of WHR
• High-risk WHR=>0.8 in females and =>0.95 in
males indicates central obesity and considered
high-risk for diabetes and cvs disorders.

35. Advantages
• Objectives with high specificity and sensitivity.
• Measures many variables of nutritional
Significance. (ht, wt, MUAC, WHR , BMI)
• Readings are numerical and gradable on
standard growth charts.
• Readings are reproducible.
• Non-expensive and needs minimal training.

36. Limitations of Anthropometry
• Inter-observers error in measurement.
• Limited nutritional diagnosis.
• Problems with reference standards i.e. local
versus international.

37. Direct methods

38. BioINITIAL LABORATORY ASSESSMENT
chemical & laboratory methods
1. Haemoglobin estimation
• most important test when accurately
measured, tells about overall state of nutrition
(anemia, and also protein and trace element
nutrition)
• Blood is collected from a finger, ear lobe or heel
prick
• Haemoglobinometres which are simple, cheap
and reasonably accurate are used

39. 2. Haematocrit or packed cell volume (PCV)
• percentage of the blood volume composed of red
cells.
• important in the diagnosis of anemia.
3. Red cell counts and blood films
• the size and uniformity of the red blood cells can
be seen.
• Use of such slides may facilitate the diagnosis of
malaria and the haemoglobinopathies.

40. 4. Stool examination
• For presence of ova and/ or intestinal
parasites
• When assessed quantitatively parasite load
can be known
5. Urine examination
• Dipstick and microscopy for albumin, sugar
and blood

41. SPECIFIC LAB TESTS
6. Measurement of nutrients in body fluids
• e.g. serum retinol, serum iron
7. Measurement of abnormal metabolites
• e.g. urinary iodide, urinary creatinine/
hydroxyapatite ratio

42. Hydroxyapatite (HA) is an inorganic mineral that has
a typical apatite lattice structure as (A10(BO4)6C2)
where A, B, and C are defined by Ca, PO4, and OH.
Pure HA contains 39.68% by weight calcium and 18%
by weight phosphorus resulting in a Ca/P mole ratio
of 1.67.

43. Advantages
• Useful in detecting early changes in body
metabolism and nutrition
• precise , accurate and reproducible.
• Useful to validate data obtained from dietary
methods e.g. comparing salt intake with 24-
hour urinary excretion.

44. Limitations of biochemical & laboratory methods
• Time consuming and expensive
• Cannot be applied on large scale
• Reveal only current nutritional status

45. CLINICAL METHODS