Nutrition assessment involves collecting information through health histories, socioeconomic histories, drug histories, diet histories, anthropometric measurements, physical examinations, and laboratory tests. This data is used to analyze an individual's or population's nutrition status and identify under-nutrition, over-nutrition, or nutrient deficiencies. Common anthropometric measurements include height, weight, skin folds, waist circumference, and waist-to-hip ratio. Physical examinations look for signs of malnutrition. Laboratory tests of blood and urine can uncover early signs of deficiencies before symptoms appear. National nutrition surveys assess populations to inform health goals and identify at-risk groups.

1. 14—Nutrition assessment
Nutrition and Fitness
Dr. Siham Gritly

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. 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. The severe wasting characteristic of marasmus
Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing
Nutrition, Twelfth Edition. 2011
Dr. Siham Gritly

5. The edema characteristic of kwashiorkor is apparent
in this child’s swollen belly. Malnourished
children commonly have an enlarged abdomen from parasites
as well. Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing
Nutrition, Twelfth Edition. 2011
Dr. Siham Gritly

6. Obese children
over nutrition
Dr. Siham Gritly

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. • 3-Physical signs and symptoms, assessment
methods; -Physical examination and
anthropometric measures
Dr. Siham Gritly

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. 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. Historical Data Used in Nutrition Assessments
Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition.
2011
Type of History What It Identifies
Health 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 problems
Socioeconomic history Personal, cultural, financial, and environmental
influences on food intake, nutrient needs, and diet
therapy options
Drug history Medications (prescription and over-the-counter),
illegal drugs, dietary supplements, and alternative
therapies that affect nutrition status
Diet history Nutrient intake excesses or deficiencies and reasons
for imbalances
Dr. Siham Gritly

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. • 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. 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. Anthropometric Measurements
Used in Nutrition Assessments
Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing
Nutrition, Twelfth Edition. 2011
Type of Measurement What It Reflects
Abdominal girth measurement Abdominal fluid retention and
abdominal organ size
Height-weight Over-nutrition and under-nutrition;
growth in children
Head circumference Brain growth and development in
infants and children under age 2
Skin-fold Subcutaneous and total body fat
Waist circumference Body fat distribution
Dr. Siham Gritly

16. Skin-fold thickness
using 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. 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. Waist or Abdominal Girth values
Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing
Nutrition, Twelfth Edition. 2011
Men Women
Risk cm inches cm inches
Very High > 120 > 47 > 110 43.5
High 100 - 120 39.5 - 47 90 - 109 35.5 – 43
Low 80 - 99 31.5 - 39 70 - 89 28.5 – 35
Very Low < 80 < 31.5 < 70 < 28.5
Dr. Siham Gritly

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. The Waist to Hip Ratio Calculator indicates your
probable health risks. People with more weight around
the waist, face more health risks than people who carry
more weight around their hips
Health Risk Based
Male Female
Solely on WHR
0.95 or below 0.80 or below Low Risk
0.96 to 1.0 0.81 to 0.85 Moderate Risk
1.0+ 0.85+ High Risk
Dr. Siham Gritly

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. 3- Physical examinations
• A third nutrition assessment technique is a
physical examination looking for clues to poor
nutrition status.
Dr. Siham Gritly

23. Physical Findings Used in Nutrition Assessments 1
Adapted from Ellie Whitney and Sharon Rady Rolfes; Under standing
.
Nutrition, Twelfth Edition 2011
Body System Healthy Findings Malnutrition Findings What the
Findings Refl
ect
Hair Shiny, firm in the scalp Dull, brittle, dry, loose; PEM
falls out
Eyes Bright, clear pink membranes Pale membranes; spots; Vitamin A, B
adjust easily to light redness adjust slowly to vitamin, zinc,
darkness and iron
Teeth and No pain or caries, gums firm Missing, discolored, Mineral and
gums teeth bright decayed teeth; gums vitamin C
bleed easily and are status
swollen and spongy
Glands No lumps Swollen at front of neck PEM and
iodine status
Tongue Red, bumpy, rough Sore, smooth, purplish, B vitamin
swollen
Dr. Siham Gritly status

24. Physical Findings Used in Nutrition
Assessments 2
Skin 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
status
Nails Firm, pink Spoon-shaped, brittle, ridged, pale Iron status
Internal Regular heart rhythm, heart Abnormal heart rate, heart rhythm, o PEM and mineral
systems 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, fatigue
Muscles and Muscle tone; posture, long “Wasted” appearance of muscles swollen PEM, mineral, and
bones 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. 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. 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. • 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. • 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. • National nutrition surveys often oversample
high-risk groups;
• *low-income families,
• * pregnant women,
• *adolescents,
• * elderly,
Dr. Siham Gritly

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