Assessment of nutritional status and nutritional history


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Assessment of nutritional status and nutritional history

  1. 1. Assessment of Nutritional Status<br />By<br />Izhar PG Scholar Dept of TST NIUM Bangalore<br />
  2. 2. IntroductionThe nutritional status of an individual is often the result of many interrelated factors.<br />Understanding these factors is essential in order to:<br /> assess malnutrition, <br /> design programmes which tackle nutrition <br /> problems, and <br /> correctly inform programme management <br /> and evaluation<br />
  3. 3. This is the most commonly used framework for understanding the causes of malnutrition.<br />(adapted from the UNICEFconceptual framework). <br />
  4. 4. Learning Objectives:<br /> To understand basic anthropometric techniques and the applications<br />
  5. 5. Nutritional Assessment Why?<br /> The purpose of nutritional assessment is to<br />Identify individual or population groups who are malnourished.<br />Identify individual or population groups at risk of becoming malnourished.<br />To develop health care programmes that meet the community needs which are defined by the assessment.<br />To measure the effectiveness of the nutritional programmes and intervention once initiated.<br />
  6. 6. Methods of Nutritional Assessment<br /> Direct and Indirect<br />
  7. 7. Direct methods of nutritional assessment:<br /> These are summarized as ABCD.<br />
  8. 8. Indirect method of nutritional assessment<br /> These included three categories.<br />
  9. 9. Clinical assessment<br />It is the simplest and most practical method of ascertaining the nutritional status of a group of individuals.<br />Detection of relevant signs helps in establishing the nutritional diagnosis.<br />
  10. 10. Clinical Assessment: Advantages <br />Fast and easy to perform<br />Inexpensive<br />Non Invasive<br />Limitations: <br />
  11. 11. Clinical Signs of nutritional deficiency<br />Hair<br />
  12. 12. Mouth<br />
  13. 13. Eyes<br />
  14. 14. Nails<br />
  15. 15. Skin<br />
  16. 16. Anthropometric methods<br /> Anthropometry is the measurement of body height, weight and proportions.<br />
  17. 17. Other anthropometric measurements<br />Mid arm circumferences<br />Skin fold thickness<br />Head circumference<br />Head/ Chest ratio<br />Hip/ Waist ratio<br />
  18. 18. Anthropometry for children<br />Accurate measurement of height and weight is essential. The results can then be used to evaluate the physical growth of the child.<br />
  19. 19. Measurement of adults<br /> Height: The subject stands erect and bare footed on a stadiometer with a movable head piece. The head piece is leveled with skull vault and height is recorded to the nearest 0.5 cm.<br />
  20. 20. Nutritional Indices in adults<br /> The international standards for assessing body size in adults is the body mass index.(BMI)<br />BMI is computed using the following formula.<br /> BMI = Weight (Kg)/ Height (met)2<br />
  21. 21. BMI ( W.H.O Classification)<br /> BMI < 18.5 = Underweight<br /> BMI 18.5 – 24.9 = Healthy weight range<br /> BMI 25 – 30 = Overweight ( Grade 1 obesity)<br /> BMI > 30 – 40 = Obese ( Grade 2 obesity)<br /> BMI > 40 = very obese ( morbid or grade 3 obesity)<br />
  22. 22. Advantages of anthropometry<br />Objective with high specificity and sensitivity.<br />Readings are numerical and gradable on standard growth charts.<br />Limitations of anthropometry<br />Inter observers errors in measurement.<br />Limited nutritional diagnosis.<br />Problems with reference standards i.e local verus international standards.<br />
  23. 23. Dietary Assessment<br /> Nutritional intake of human is assesses by five different methods. These are<br /> 24 hours dietary recall.<br /> Food frequency questionnaire.<br /> Dietary history since early life.<br /> Food dairy technique.<br /> Observed food consumption.<br />
  24. 24. Initial laboratory assessment<br />Hb estimation is the most important test and useful index of the overall state of nutrition. <br />Specific lab tests<br />Measurement of individual nutrient in body fluids( e.g serum reinol, serum iron, urinary iodine, vit D)<br />Detection of abnormal amount of metabolites in urine ( e.g urinary creatinine)<br />Analysis of hair, nails and skin for micronutrients.<br />
  25. 25. Advantages of biochmical method<br />It is useful in detecting early changes in body metabolism and nutrition before the appearance of overt clinical signs.<br />It is precise, accurate and reproducible.<br />Limitations<br />Time consuming<br />expensive<br />
  26. 26. If you want to know more……………<br />Nutrition and development: a global challenge - adapted from Nutrition and development - a global assessment, written by FAO and WHO for the International Conference on Nutrition, 1992.<br /> United Nations Standing Committee on Nutrition/Administrative Committee on Coordination(ACC/SCN) Second report on the World Nutrition Situation: Vol.1: Global and Regional Results, ACC/SCN Geneva, 1992.<br /> The double burden of malnutrition – Case studies from six developing countries. FAO Food and Nutrition Paper 84, Rome 2006.<br /> Measurement and Assessment of Food Deprivation and Undernutrition - FIVIMS Proceedings, International Scientific Symposium held in FAO, Rome 26-28 June 2002. FAO 2003.<br /> Conducting small-scale nutrition surveys: A field manual. FAO, 1990, 186p, English, Spanish, French ISBN 202851.<br /> Body mass index - A measure of chronic energy deficiency in adults. FAO Food and Nutrition Paper 56, 1994.<br />
  27. 27. Thank you….<br />