This document provides an overview of nutrition assessment and classification. It discusses the importance of nutrition assessment, different types of assessments including anthropometric, biochemical, clinical and dietary assessments. It describes nutrition screening and explains how to prioritize clients for assessment. Key aspects like frequency of assessment and indicators used to classify nutritional status are also outlined. The document is an educational resource for health workers on conducting comprehensive nutrition assessments.
Nutritional assessment involves direct and indirect methods to evaluate community nutritional status. Direct methods include anthropometric measurements, dietary evaluations, clinical assessments, and biochemical tests. Anthropometric measurements like height, weight, and body mass index are key to assessing malnutrition. Dietary assessments like 24-hour recalls and food frequency questionnaires evaluate food and nutrient intake. Clinical exams identify physical signs of deficiencies. Biochemical tests like hemoglobin levels also help establish nutritional status. Collectively, these methods provide important data for identifying nutritional problems and developing effective intervention programs.
This document discusses methods of nutritional assessment. It defines nutritional status and outlines the purpose of nutritional assessment as identifying those at risk of malnutrition and measuring the effectiveness of nutrition programs. Methods of assessment include direct anthropometric measurements like height, weight, and body mass index, as well as indirect methods like economic factors and health statistics. Clinical assessment examines physical signs associated with malnutrition. Both direct and indirect methods are used to evaluate undernutrition and overnutrition.
nutritional status assessment using Anthropometry, Biochemical, Clinical and ...DrVaishali3
The document discusses various methods for assessing nutritional status, including anthropometric, biochemical, clinical, and dietary assessments. Anthropometric methods like height, weight, mid-upper arm circumference, and skin fold thickness measurements are described as the most widely used and provide objective data on nutritional status. Biochemical indicators like hemoglobin and micronutrient levels in blood and urine are also evaluated. Clinical examination can detect early signs of nutritional deficiencies. Dietary assessment methods ranging from national food balance sheets to individual food recalls and records are outlined.
The nutritional status of an individual is determined by a complex interaction between internal constitutional factors like age, sex, nutrition, and diseases, and external environmental factors like food safety, and socioeconomic circumstances. Nutritional status can be optimal, undernourished, overnourished, or malnourished. Nutritional assessment methods include anthropometric measurements like height, weight, and BMI; clinical examination; dietary evaluation; and biochemical tests to identify individuals at risk of malnutrition and evaluate nutritional programs.
The document discusses various methods for assessing nutritional status, including direct and indirect methods. Direct methods include anthropometric measurements, clinical assessment, dietary evaluation, and biochemical/laboratory tests. Anthropometric measurements include height, weight, mid-arm circumference, and skin fold thickness. Clinical assessment examines physical signs of malnutrition. Dietary evaluation involves dietary recalls, food frequency questionnaires, and food diaries. Biochemical tests include hemoglobin levels and micronutrient levels in blood and urine. Indirect methods assess broader community factors like economic conditions, food availability, and health statistics.
This document provides an overview of nutritional assessment methods. It discusses direct methods like anthropometric, biochemical, clinical and dietary assessments. Anthropometric methods measure body height, weight and proportions to evaluate undernutrition and overnutrition. Biochemical tests measure nutrient levels in the body. Clinical assessment examines physical signs associated with malnutrition. Dietary assessment evaluates food intake. Indirect methods include analyzing ecological, economic and vital health statistics that reflect nutritional influences. The document outlines each assessment method in detail and their advantages and limitations. The goal of nutritional assessment is to identify individuals and groups at risk of malnutrition and to evaluate nutritional programs.
Assessment Methods For Nutritional StatusDrSindhuAlmas
By the end of this lecture the you should be able:
To know the different methods for assessing the nutritional status To understand the basic anthropometric techniques, applications, & reference standards
Nutritional Assessment METHOD POWER POINT.pptMoamoiAddoo
This document provides information on nutritional assessment methods. It discusses direct and indirect assessment methods. Direct methods include anthropometric, biochemical, clinical, and dietary assessments. Anthropometric assessments measure body dimensions and proportions. Key anthropometric measurements discussed are head circumference, length/height, weight, and indices derived from these measurements. The document outlines several methods to classify nutritional status based on anthropometric indices, including Gomez, Wellcome Trust, and Waterlow classifications. It also discusses using anthropometry to assess body composition in adults.
Nutritional assessment involves direct and indirect methods to evaluate community nutritional status. Direct methods include anthropometric measurements, dietary evaluations, clinical assessments, and biochemical tests. Anthropometric measurements like height, weight, and body mass index are key to assessing malnutrition. Dietary assessments like 24-hour recalls and food frequency questionnaires evaluate food and nutrient intake. Clinical exams identify physical signs of deficiencies. Biochemical tests like hemoglobin levels also help establish nutritional status. Collectively, these methods provide important data for identifying nutritional problems and developing effective intervention programs.
This document discusses methods of nutritional assessment. It defines nutritional status and outlines the purpose of nutritional assessment as identifying those at risk of malnutrition and measuring the effectiveness of nutrition programs. Methods of assessment include direct anthropometric measurements like height, weight, and body mass index, as well as indirect methods like economic factors and health statistics. Clinical assessment examines physical signs associated with malnutrition. Both direct and indirect methods are used to evaluate undernutrition and overnutrition.
nutritional status assessment using Anthropometry, Biochemical, Clinical and ...DrVaishali3
The document discusses various methods for assessing nutritional status, including anthropometric, biochemical, clinical, and dietary assessments. Anthropometric methods like height, weight, mid-upper arm circumference, and skin fold thickness measurements are described as the most widely used and provide objective data on nutritional status. Biochemical indicators like hemoglobin and micronutrient levels in blood and urine are also evaluated. Clinical examination can detect early signs of nutritional deficiencies. Dietary assessment methods ranging from national food balance sheets to individual food recalls and records are outlined.
The nutritional status of an individual is determined by a complex interaction between internal constitutional factors like age, sex, nutrition, and diseases, and external environmental factors like food safety, and socioeconomic circumstances. Nutritional status can be optimal, undernourished, overnourished, or malnourished. Nutritional assessment methods include anthropometric measurements like height, weight, and BMI; clinical examination; dietary evaluation; and biochemical tests to identify individuals at risk of malnutrition and evaluate nutritional programs.
The document discusses various methods for assessing nutritional status, including direct and indirect methods. Direct methods include anthropometric measurements, clinical assessment, dietary evaluation, and biochemical/laboratory tests. Anthropometric measurements include height, weight, mid-arm circumference, and skin fold thickness. Clinical assessment examines physical signs of malnutrition. Dietary evaluation involves dietary recalls, food frequency questionnaires, and food diaries. Biochemical tests include hemoglobin levels and micronutrient levels in blood and urine. Indirect methods assess broader community factors like economic conditions, food availability, and health statistics.
This document provides an overview of nutritional assessment methods. It discusses direct methods like anthropometric, biochemical, clinical and dietary assessments. Anthropometric methods measure body height, weight and proportions to evaluate undernutrition and overnutrition. Biochemical tests measure nutrient levels in the body. Clinical assessment examines physical signs associated with malnutrition. Dietary assessment evaluates food intake. Indirect methods include analyzing ecological, economic and vital health statistics that reflect nutritional influences. The document outlines each assessment method in detail and their advantages and limitations. The goal of nutritional assessment is to identify individuals and groups at risk of malnutrition and to evaluate nutritional programs.
Assessment Methods For Nutritional StatusDrSindhuAlmas
By the end of this lecture the you should be able:
To know the different methods for assessing the nutritional status To understand the basic anthropometric techniques, applications, & reference standards
Nutritional Assessment METHOD POWER POINT.pptMoamoiAddoo
This document provides information on nutritional assessment methods. It discusses direct and indirect assessment methods. Direct methods include anthropometric, biochemical, clinical, and dietary assessments. Anthropometric assessments measure body dimensions and proportions. Key anthropometric measurements discussed are head circumference, length/height, weight, and indices derived from these measurements. The document outlines several methods to classify nutritional status based on anthropometric indices, including Gomez, Wellcome Trust, and Waterlow classifications. It also discusses using anthropometry to assess body composition in adults.
nutritional assessment - a community based survey/study performed in children.
Anthropometry holds an important position in the assessment of nutrition.
it comprises easy and simple tools that can be analysed by ASHAs and ANMs at community level too apart from physicians.
This document discusses methods for assessing nutritional status in children, including direct methods like anthropometric measurements, biochemical tests, clinical examination, and dietary evaluation as well as indirect community-level methods. Anthropometric measurements like weight, height, mid-upper arm circumference are useful objective measures that can be plotted on growth charts. Clinical examination looks for physical signs of deficiencies. Biochemical tests can detect early changes before symptoms. Dietary assessment methods include 24-hour recall, food frequency questionnaires, and food diaries. The goals of assessment are to identify malnutrition, define health risks, and inform treatment.
Growth monitoring is used to assess whether a child's growth is normal or indicates potential health issues. It involves regularly measuring a child's height, weight, and other factors and plotting them on standardized growth charts. Abnormal growth may signal problems like malnutrition or disease. Key aspects of growth monitoring include using accurate measuring techniques and growth charts, identifying growth patterns outside the normal range, and taking appropriate actions like counseling or referral for further evaluation if issues are suspected.
Nutritional assessment is an important tool that involves evaluating an individual's food and nutrient intake, lifestyle, medical history, and anthropometric, body composition, and biochemical measurements. It can identify people at risk of malnutrition and determine the effectiveness of nutrition programs. Common methods of assessment include analyzing anthropometric data like height, weight, and skin fold thickness; dietary intake; clinical exams; and biochemical tests. Assessments help design interventions, provide baseline data, and evaluate progress in addressing malnutrition at individual and population levels.
The document discusses guidelines for performing physical examinations of children and adolescents as part of preventive care visits. It focuses on accurately measuring growth indicators like height, weight, head circumference, and calculating BMI. Deviations from normal ranges may indicate underlying medical issues. The document provides detailed instructions for taking measurements and interpreting abnormal results. Key aspects to assess include growth trajectories, weight status, neurological development, and identifying children who may require medical follow-up or referrals.
The document discusses various methods for assessing nutritional status, including direct and indirect methods. Direct methods include anthropometric measurements like height, weight, skin folds, and body mass index (BMI). Clinical examination looks for signs of deficiencies. Dietary assessment methods are 24-hour recall, food frequency questionnaires, and food diaries. Laboratory tests include hemoglobin, micronutrient levels, and biomarkers. Anthropometry is useful but has limitations. Dietary assessment and clinical exams provide additional information. Biochemical tests can detect early changes but are more complex. Overall, a combination of methods is recommended to fully evaluate nutritional status.
The document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, biochemical tests, clinical exams, and dietary assessments, as well as indirect demographic and health metrics. Anthropometric measurements like height, weight, waist circumference, and body mass index are useful but have limitations. Clinical exams can detect signs of deficiencies but miss early cases. Biochemical tests provide accurate data but are complex and expensive. Dietary assessments include 24-hour recalls, food frequency questionnaires, and food diaries. Overall, a combination of assessments is best to evaluate both individuals and populations.
Nutritional assessment of foods and its methodsThiviKutty
The document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, clinical examinations, biochemical tests, and dietary evaluations. It provides details on anthropometric indicators like BMI, waist-to-hip ratio, and growth charts. Clinical signs of nutrient deficiencies are also outlined. The advantages and limitations of different assessment methods are reviewed.
This document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, biochemical tests, clinical exams, and dietary evaluations as well as indirect methods using community health data. It provides details on anthropometric indicators like BMI, waist circumference, and hip measurements. Clinical exams can identify signs of deficiencies in hair, mouth, eyes, nails, skin, thyroid, and bones. Biochemical tests of blood and urine are useful to detect early nutritional changes. Dietary assessments include 24-hour recalls, food frequency questionnaires, and food diaries.
The document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, biochemical tests, clinical exams, and dietary evaluations. It describes techniques for anthropometry like measuring height, weight, waist circumference, and calculating BMI. Clinical exams can identify signs of deficiencies. Dietary assessments include 24-hour recalls, food frequency questionnaires, and food diaries. Both direct and indirect community-level methods are used to identify nutritional risks and evaluate programs.
This document discusses dietary assessment and counseling in dental practice. It describes how diet can impact oral health through oral environment and general nutrition. Methods for assessing dietary intake include 24-hour recalls, dietary records, and food frequency questionnaires. BMI is used to screen for weight categories in children and teens. Dietary intake is evaluated for cariogenic potential and nutritive value, then counseling is provided to help motivate patients to modify their diet and improve oral health.
This document discusses assessing dietary intake and nutritional status in dental practice. It describes how body mass index (BMI) is calculated and interpreted for children and teens to screen for weight categories. It also discusses various methods for assessing dietary intake, including 24-hour recalls, dietary records, and food frequency questionnaires. The objectives and process of evaluating dietary intake and nutritive value are outlined.
Free weight loss and diet tips for healthy eating and portion control of foodPrab Tumpati
This is a public domain document from the state of Vermont with excellent points on portion control. 20 years ago, a typical bagel was 3” and 140 calories. Today, a typical bagel is 6” and 360 calories.
The larger bagel is an extra 200 calories. Eating 22 extra calories a day equals a weight gain of 23 pounds a year.
As we welcome the new year 2014, it is important to make a resolution to reduce portions as even cutting down by by a small amount a day can add up.
The other very important and often misunderstood aspect of the foods is the glycemic index of foods. For example, a typical bagel has a very high glycemic index of over 70 percent leading what is called "sugar rush" and "sugar crash". This phenomenon is so common that this is what drives the hunger in most people! This also leads to insulin resistance, metabolic syndrome, prediabetes, and diabetes.
How does glycemic index affect us?
Your body quickly digests the starches found in bagels, which causes your blood sugar levels to rise quickly and a few hours later, it leads to the crash. The higher the glycemic index of a food, the more it affects your blood sugar levels. Table sugar or sucrose has a glycemic index of 60, while the glycemic index of bagels averages 70 - a bagel is worse than even sugar. A breakfast rich in high-glycemic foods such as bagels can predispose you to weight gain, type 2 diabetes and heart problems.
In fact, Sumo wrestlers in Japan intentionally eat high glycemic diet for rapid weight gain, and there are reports that body builders in USA are intentionally using this principle of insulin resistance leading quick weight gain for their benefit by using insulin. According to the CDC, a third of all US adults are prediabetic or insulin resistant, and another third have some degree of it!
According to Dr. Prab R. Tumpati, MD, founder of W8MD medical weight loss centers of America, our obsession with low fatty foods as advocated by the failed food pyramid in fact contributed to our expanding waist lines by way of increased insulin resistance which in turn causes weight gain!
If you are overweight or obese, have excess belly fat, or have metabolic syndrome, pre-diabetes, or diabetes, and need help losing weight with health insurance, w8md medical weight loss centers of America can help! Check out our youtube channel with 52 weeks of weight loss and wellness videos at http://www.youtube.com/w8md
Service providers who receive high nutrition risk referrals, particularly Registered Dietitians, need to be knowledgeable about general and clinical pediatric nutrition as well as counselling skills for working with families and children.
This is the first of five self-directed training modules available in PowerPoint presentations that have been developed and evaluated to respond to this need
This document discusses various methods for nutritional assessment, including direct and indirect methods. Direct methods measure anthropometry, biochemical/biophysical markers, clinical signs, and dietary intake. Anthropometry includes measurements like height, weight, mid-upper arm circumference, and skin folds which can assess growth in children and body composition in adults. Biochemical tests measure nutrient levels in tissues or fluids. Clinical methods observe signs of deficiencies. Dietary assessments evaluate past and current nutrient intake. Indirect methods examine broader health and socioeconomic indicators related to malnutrition. The document provides details on each assessment type and their advantages and limitations.
This document provides an overview of anthropometric assessments. It defines anthropometry as the measurement of human physical dimensions and composition. It discusses various anthropometric measurements including height, weight, mid-upper arm circumference, and skin folds that are used to assess growth in children and body composition in adults. It also describes how indices like weight-for-age, height-for-age, and body mass index are derived from these measurements and used to classify nutritional status. Quality control measures for anthropometric surveys are also outlined to ensure accurate data collection.
Nutritional status is determined by the balance between food intake and energy expenditure, and is influenced by both internal factors like age and diseases as well as external environmental factors like food safety and socioeconomics. Nutritional assessment involves evaluating subjective and objective data related to food/nutrient intake, lifestyle, and medical history to identify undernutrition, overnutrition, deficiencies, and those at risk. It is done through various methods including dietary surveys, anthropometric measurements, biochemical tests, and clinical examinations. Regular growth monitoring is important for screening for nutritional and health issues in children.
Mannan 6b anthropometricand nutritional status indicatorsSizwan Ahammed
The document summarizes concepts and measurement of nutrition status. It discusses various indicators used to assess malnutrition including anthropometric measurements like stunting, wasting, underweight; BMI; and biochemical indicators of micronutrient deficiencies. Stunting, wasting and underweight are defined based on height-for-age, weight-for-height, and weight-for-age z-scores. Mid-upper arm circumference is also used. The most common micronutrient deficiencies are vitamin A, iodine and iron which are measured using biochemical indicators like serum retinol, urinary iodine and serum ferritin levels respectively.
Nutritional Assessment of Individual, Family & Community CM 5.2.pptxCommunityMedicine46
This document provides an overview of methods for assessing nutritional status, including direct and indirect methods. Direct methods include clinical, anthropometric, dietary, and laboratory assessments. Clinical assessment involves a physical exam to identify signs of malnutrition. Anthropometric methods measure height, weight, and other body proportions. Dietary assessment evaluates food intake through methods like 24-hour recalls. Laboratory tests analyze blood and other biomarkers. Indirect methods review health statistics, ecological variables, and socioeconomic factors that influence nutrition. The document outlines the advantages and limitations of each assessment type.
Determination of Nutritional Status semester 4.2.pptAkuraUkukAjabu
This document discusses various methods for assessing nutritional status, including direct and indirect methods. Direct methods include anthropometric measurements like height, weight, skin folds; clinical examination of signs of deficiency; and dietary assessments like 24-hour recalls and food frequency questionnaires. Anthropometry is useful for evaluating undernutrition and overnutrition by comparing measurements to reference standards. Clinical examination identifies individuals at nutritional risk by checking for physical signs associated with deficiencies. Dietary assessments provide information on nutrient intake. Indirect methods consider community-level factors like food production and health statistics. Laboratory tests can detect early nutritional changes and validate other assessment methods.
HEALTH PRESENTATION PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPWILLIAMSADU1
This document provides a performance review for the Salvation Army Clinic in Akim Wenchi for the end of 2023. It includes sections on key issues, facility profile, staff strength, facility performance, best practices, achievements, challenges, and the way forward. Some highlights include immunization rates between 88-103% for various vaccines, 318 FP acceptors in 2021 increasing to 384 in 2023, and OPD attendance increasing from 5,118 in 2021 to 6,511 in 2023. Financial reports show total income of GH¢600,847 and total expenses of GH¢596,322 for 2023.
nutritional assessment - a community based survey/study performed in children.
Anthropometry holds an important position in the assessment of nutrition.
it comprises easy and simple tools that can be analysed by ASHAs and ANMs at community level too apart from physicians.
This document discusses methods for assessing nutritional status in children, including direct methods like anthropometric measurements, biochemical tests, clinical examination, and dietary evaluation as well as indirect community-level methods. Anthropometric measurements like weight, height, mid-upper arm circumference are useful objective measures that can be plotted on growth charts. Clinical examination looks for physical signs of deficiencies. Biochemical tests can detect early changes before symptoms. Dietary assessment methods include 24-hour recall, food frequency questionnaires, and food diaries. The goals of assessment are to identify malnutrition, define health risks, and inform treatment.
Growth monitoring is used to assess whether a child's growth is normal or indicates potential health issues. It involves regularly measuring a child's height, weight, and other factors and plotting them on standardized growth charts. Abnormal growth may signal problems like malnutrition or disease. Key aspects of growth monitoring include using accurate measuring techniques and growth charts, identifying growth patterns outside the normal range, and taking appropriate actions like counseling or referral for further evaluation if issues are suspected.
Nutritional assessment is an important tool that involves evaluating an individual's food and nutrient intake, lifestyle, medical history, and anthropometric, body composition, and biochemical measurements. It can identify people at risk of malnutrition and determine the effectiveness of nutrition programs. Common methods of assessment include analyzing anthropometric data like height, weight, and skin fold thickness; dietary intake; clinical exams; and biochemical tests. Assessments help design interventions, provide baseline data, and evaluate progress in addressing malnutrition at individual and population levels.
The document discusses guidelines for performing physical examinations of children and adolescents as part of preventive care visits. It focuses on accurately measuring growth indicators like height, weight, head circumference, and calculating BMI. Deviations from normal ranges may indicate underlying medical issues. The document provides detailed instructions for taking measurements and interpreting abnormal results. Key aspects to assess include growth trajectories, weight status, neurological development, and identifying children who may require medical follow-up or referrals.
The document discusses various methods for assessing nutritional status, including direct and indirect methods. Direct methods include anthropometric measurements like height, weight, skin folds, and body mass index (BMI). Clinical examination looks for signs of deficiencies. Dietary assessment methods are 24-hour recall, food frequency questionnaires, and food diaries. Laboratory tests include hemoglobin, micronutrient levels, and biomarkers. Anthropometry is useful but has limitations. Dietary assessment and clinical exams provide additional information. Biochemical tests can detect early changes but are more complex. Overall, a combination of methods is recommended to fully evaluate nutritional status.
The document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, biochemical tests, clinical exams, and dietary assessments, as well as indirect demographic and health metrics. Anthropometric measurements like height, weight, waist circumference, and body mass index are useful but have limitations. Clinical exams can detect signs of deficiencies but miss early cases. Biochemical tests provide accurate data but are complex and expensive. Dietary assessments include 24-hour recalls, food frequency questionnaires, and food diaries. Overall, a combination of assessments is best to evaluate both individuals and populations.
Nutritional assessment of foods and its methodsThiviKutty
The document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, clinical examinations, biochemical tests, and dietary evaluations. It provides details on anthropometric indicators like BMI, waist-to-hip ratio, and growth charts. Clinical signs of nutrient deficiencies are also outlined. The advantages and limitations of different assessment methods are reviewed.
This document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, biochemical tests, clinical exams, and dietary evaluations as well as indirect methods using community health data. It provides details on anthropometric indicators like BMI, waist circumference, and hip measurements. Clinical exams can identify signs of deficiencies in hair, mouth, eyes, nails, skin, thyroid, and bones. Biochemical tests of blood and urine are useful to detect early nutritional changes. Dietary assessments include 24-hour recalls, food frequency questionnaires, and food diaries.
The document discusses various methods for assessing nutritional status, including direct methods like anthropometric measurements, biochemical tests, clinical exams, and dietary evaluations. It describes techniques for anthropometry like measuring height, weight, waist circumference, and calculating BMI. Clinical exams can identify signs of deficiencies. Dietary assessments include 24-hour recalls, food frequency questionnaires, and food diaries. Both direct and indirect community-level methods are used to identify nutritional risks and evaluate programs.
This document discusses dietary assessment and counseling in dental practice. It describes how diet can impact oral health through oral environment and general nutrition. Methods for assessing dietary intake include 24-hour recalls, dietary records, and food frequency questionnaires. BMI is used to screen for weight categories in children and teens. Dietary intake is evaluated for cariogenic potential and nutritive value, then counseling is provided to help motivate patients to modify their diet and improve oral health.
This document discusses assessing dietary intake and nutritional status in dental practice. It describes how body mass index (BMI) is calculated and interpreted for children and teens to screen for weight categories. It also discusses various methods for assessing dietary intake, including 24-hour recalls, dietary records, and food frequency questionnaires. The objectives and process of evaluating dietary intake and nutritive value are outlined.
Free weight loss and diet tips for healthy eating and portion control of foodPrab Tumpati
This is a public domain document from the state of Vermont with excellent points on portion control. 20 years ago, a typical bagel was 3” and 140 calories. Today, a typical bagel is 6” and 360 calories.
The larger bagel is an extra 200 calories. Eating 22 extra calories a day equals a weight gain of 23 pounds a year.
As we welcome the new year 2014, it is important to make a resolution to reduce portions as even cutting down by by a small amount a day can add up.
The other very important and often misunderstood aspect of the foods is the glycemic index of foods. For example, a typical bagel has a very high glycemic index of over 70 percent leading what is called "sugar rush" and "sugar crash". This phenomenon is so common that this is what drives the hunger in most people! This also leads to insulin resistance, metabolic syndrome, prediabetes, and diabetes.
How does glycemic index affect us?
Your body quickly digests the starches found in bagels, which causes your blood sugar levels to rise quickly and a few hours later, it leads to the crash. The higher the glycemic index of a food, the more it affects your blood sugar levels. Table sugar or sucrose has a glycemic index of 60, while the glycemic index of bagels averages 70 - a bagel is worse than even sugar. A breakfast rich in high-glycemic foods such as bagels can predispose you to weight gain, type 2 diabetes and heart problems.
In fact, Sumo wrestlers in Japan intentionally eat high glycemic diet for rapid weight gain, and there are reports that body builders in USA are intentionally using this principle of insulin resistance leading quick weight gain for their benefit by using insulin. According to the CDC, a third of all US adults are prediabetic or insulin resistant, and another third have some degree of it!
According to Dr. Prab R. Tumpati, MD, founder of W8MD medical weight loss centers of America, our obsession with low fatty foods as advocated by the failed food pyramid in fact contributed to our expanding waist lines by way of increased insulin resistance which in turn causes weight gain!
If you are overweight or obese, have excess belly fat, or have metabolic syndrome, pre-diabetes, or diabetes, and need help losing weight with health insurance, w8md medical weight loss centers of America can help! Check out our youtube channel with 52 weeks of weight loss and wellness videos at http://www.youtube.com/w8md
Service providers who receive high nutrition risk referrals, particularly Registered Dietitians, need to be knowledgeable about general and clinical pediatric nutrition as well as counselling skills for working with families and children.
This is the first of five self-directed training modules available in PowerPoint presentations that have been developed and evaluated to respond to this need
This document discusses various methods for nutritional assessment, including direct and indirect methods. Direct methods measure anthropometry, biochemical/biophysical markers, clinical signs, and dietary intake. Anthropometry includes measurements like height, weight, mid-upper arm circumference, and skin folds which can assess growth in children and body composition in adults. Biochemical tests measure nutrient levels in tissues or fluids. Clinical methods observe signs of deficiencies. Dietary assessments evaluate past and current nutrient intake. Indirect methods examine broader health and socioeconomic indicators related to malnutrition. The document provides details on each assessment type and their advantages and limitations.
This document provides an overview of anthropometric assessments. It defines anthropometry as the measurement of human physical dimensions and composition. It discusses various anthropometric measurements including height, weight, mid-upper arm circumference, and skin folds that are used to assess growth in children and body composition in adults. It also describes how indices like weight-for-age, height-for-age, and body mass index are derived from these measurements and used to classify nutritional status. Quality control measures for anthropometric surveys are also outlined to ensure accurate data collection.
Nutritional status is determined by the balance between food intake and energy expenditure, and is influenced by both internal factors like age and diseases as well as external environmental factors like food safety and socioeconomics. Nutritional assessment involves evaluating subjective and objective data related to food/nutrient intake, lifestyle, and medical history to identify undernutrition, overnutrition, deficiencies, and those at risk. It is done through various methods including dietary surveys, anthropometric measurements, biochemical tests, and clinical examinations. Regular growth monitoring is important for screening for nutritional and health issues in children.
Mannan 6b anthropometricand nutritional status indicatorsSizwan Ahammed
The document summarizes concepts and measurement of nutrition status. It discusses various indicators used to assess malnutrition including anthropometric measurements like stunting, wasting, underweight; BMI; and biochemical indicators of micronutrient deficiencies. Stunting, wasting and underweight are defined based on height-for-age, weight-for-height, and weight-for-age z-scores. Mid-upper arm circumference is also used. The most common micronutrient deficiencies are vitamin A, iodine and iron which are measured using biochemical indicators like serum retinol, urinary iodine and serum ferritin levels respectively.
Nutritional Assessment of Individual, Family & Community CM 5.2.pptxCommunityMedicine46
This document provides an overview of methods for assessing nutritional status, including direct and indirect methods. Direct methods include clinical, anthropometric, dietary, and laboratory assessments. Clinical assessment involves a physical exam to identify signs of malnutrition. Anthropometric methods measure height, weight, and other body proportions. Dietary assessment evaluates food intake through methods like 24-hour recalls. Laboratory tests analyze blood and other biomarkers. Indirect methods review health statistics, ecological variables, and socioeconomic factors that influence nutrition. The document outlines the advantages and limitations of each assessment type.
Determination of Nutritional Status semester 4.2.pptAkuraUkukAjabu
This document discusses various methods for assessing nutritional status, including direct and indirect methods. Direct methods include anthropometric measurements like height, weight, skin folds; clinical examination of signs of deficiency; and dietary assessments like 24-hour recalls and food frequency questionnaires. Anthropometry is useful for evaluating undernutrition and overnutrition by comparing measurements to reference standards. Clinical examination identifies individuals at nutritional risk by checking for physical signs associated with deficiencies. Dietary assessments provide information on nutrient intake. Indirect methods consider community-level factors like food production and health statistics. Laboratory tests can detect early nutritional changes and validate other assessment methods.
HEALTH PRESENTATION PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPWILLIAMSADU1
This document provides a performance review for the Salvation Army Clinic in Akim Wenchi for the end of 2023. It includes sections on key issues, facility profile, staff strength, facility performance, best practices, achievements, challenges, and the way forward. Some highlights include immunization rates between 88-103% for various vaccines, 318 FP acceptors in 2021 increasing to 384 in 2023, and OPD attendance increasing from 5,118 in 2021 to 6,511 in 2023. Financial reports show total income of GH¢600,847 and total expenses of GH¢596,322 for 2023.
lecture 1 Course outline of internal medicineWILLIAMSADU1
This document provides an overview of the Internal Medicine II course. The course focuses on diseases of the endocrine, genitourinary, musculo-skeletal, and immune systems. It also covers diseases of the ear, nose, throat, eyes, and skin. Course objectives include describing and explaining diseases and disorders of these body systems and their management. The course will be delivered through lectures, case studies, seminars, bedside teaching and other participatory methods. Students will be assessed through assignments, quizzes, and an end of semester exam.
health system management. the second partWILLIAMSADU1
This document provides an overview of a health systems management course. The course introduces concepts in managing health sector resources, including financing, equipment, logistics, and health information systems. The course objectives are to explain resource management principles and describe finance and audit processes. Content covers managing resources, equipment, logistics, finance, audit, and health information systems. Modes of delivery include lectures, case studies, seminars, group work, role plays, field trips, and tutorials. Student evaluation includes practical attachments and continuous/end of term assessments.
[/SUMMARY]
HEALTH SYSTEMS MANAGEMENT II UNIT TWO [Autosaved].pptxWILLIAMSADU1
This document discusses human resource management for health systems. It covers estimating staffing needs using different approaches like population ratios or service targets. Recruitment and selection processes are described involving advertising positions, shortlisting candidates, and conducting interviews. Effective communication in health systems requires downward, upward, and horizontal information sharing through various channels while minimizing barriers. Motivating staff can be achieved by ensuring a good work environment, recognition, opportunities for advancement, and training.
HEALTH SYSTEMS MANAGEMENT II UNIT THREE.pptxWILLIAMSADU1
This document provides an overview of managing finances in health systems. It discusses various sources of funds for health services including user fees, community health funds, and donor support. It also outlines proper accounting procedures for maintaining financial records such as ledgers, cash books, and receipts. The objectives of the course are to familiarize participants with accounting procedures, financial documentation, and budgeting and reporting processes.
Abdominal trauma can range from minor bruising to major internal injuries and is caused by events like car accidents, falls, or direct blows. Symptoms include pain, tenderness, nausea, vomiting and difficulty breathing. Doctors diagnose abdominal trauma through physical exams, CT scans and ultrasounds. Treatment depends on severity but may include rest, pain medication or surgery. It is important to follow a doctor's instructions on care after abdominal trauma and get follow-up appointments. People can reduce risk by wearing seatbelts, protective gear, being aware of surroundings, and getting regular check-ups.
This document discusses prevention of mother-to-child transmission (PMTCT) of HIV. PMTCT aims to reduce the risk of HIV transmission from an HIV-positive mother to her child through antenatal care, HIV testing, antiretroviral therapy, safe delivery practices, postnatal care, and informed breastfeeding guidelines. Barriers to effective PMTCT include HIV stigma, limited healthcare access, lack of awareness, and weak healthcare systems. Strategies to overcome these barriers include public education, expanding healthcare services, mobile clinics, and investments in healthcare infrastructure. With comprehensive PMTCT strategies, the risk of mother-to-child HIV transmission can be significantly reduced.
This document provides an overview of wound classification and the wound healing process. It begins with the objectives and defines a wound. It then classifies wounds according to surface covering, depth of injury, cause, type of injury, and degree of contamination. The stages of wound healing are described as inflammatory, proliferative, and maturation phases. Key processes in the proliferative phase include granulation, wound contraction, and epithelialization which work to fill the wound with new tissue and close it.
This document discusses respiratory pharmacology, focusing on drugs used to treat asthma and COPD. It describes different inhaler devices and classes of drugs including bronchodilators, anti-inflammatories, methylxanthines, anticholinergics, and leukotriene inhibitors. Specific drugs are discussed within each class, along with their dosages, durations of action, routes of administration, and adverse effects. Treatment guidelines for varying levels of asthma and COPD severity are also reviewed.
The document discusses severe acute malnutrition (SAM) in children, defining it as very low weight-for-height, visible severe wasting, or bilateral pitting edema in children aged 6-59 months. SAM can be caused by inadequate dietary intake, illness, or a combination of both. It presents clinically as marasmus, kwashiorkor, or marasmic-kwashiorkor and puts children at high risk of death from common illnesses like diarrhea and pneumonia.
This presentation discusses elephantiasis, also known as lymphatic filariasis. It is caused by filarial worms being transmitted via mosquito bites, infecting the lymphatic system and causing blockages. This leads to swelling of the limbs and genitals. It occurs commonly in areas with poor sanitation. The life cycle involves microfilariae infecting mosquitoes which then transmit the parasite during blood meals. Diagnosis involves identifying the parasite via blood samples, tissues, or clinical symptoms like swelling. Treatment involves preventative drugs and antibiotics, while management focuses on wound care, exercises, and addressing psychological impacts of disfigurement. Complications can include disability, necrosis, and secondary infections if not properly cared for.
The document discusses concepts of mental illness including myths and causes, noting that mental illness results from a combination of biological, psychological, and environmental factors interacting in complex ways, and outlines approaches to prevention and general nursing management of mental illness including meeting patients' physical, psychological, and social needs.
This document discusses urinary tract infections (UTIs), including different types of UTIs like cystitis and pyelonephritis. It lists personal hygiene practices that can increase risk of UTIs like improper wiping after using the bathroom. It also provides details on common symptoms of a UTI like pain or burning during urination, frequent urges to urinate but little coming out, and cloudy or smelly urine. Symptoms can also include back or abdominal pain, fatigue, and fever.
This document discusses 8 essential amino acids: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Each section provides information on the amino acid's functions in the body, food sources, potential deficiency symptoms if intake is inadequate, and possible overdose effects from excessive intake. The amino acids are building blocks of proteins and play various important roles in growth, tissue repair, hormone production, and neurological functioning.
This document provides an overview of human reproduction from both male and female anatomical perspectives. It describes the similarities and differences between male and female reproductive systems, how gender is determined, the menstrual cycle and hormonal regulation in females, the process of fertilization and fetal development, and concludes with a discussion of twins and breastfeeding. Key points covered include that males produce millions of sperm daily while females typically release one egg per month, fertilization occurs when a sperm penetrates an egg in the fallopian tubes, and a zygote then implants in the uterus and receives nutrients from the mother's blood via the placenta.
This document provides an outline for a lecture on biology. It begins with an introduction to biology and its major branches. It then discusses important pioneers in biology such as Aristotle, Hippocrates, Leeuwenhoek, Lister, Fleming, Salk, and Sabin. The major themes of biology are then outlined including cell structure and function, homeostasis, reproduction and inheritance, evolution, interdependence of organisms, and matter, energy, and organization. Scientific method is also summarized. The document concludes with a discussion of the domains and kingdoms of life.
1. Enzymes are biological catalysts that speed up chemical reactions without being consumed in the process. They do this by lowering the activation energy of reactions.
2. Most enzymes are proteins that contain an active site where substrates bind and reactions occur. Enzymes exhibit high specificity and can accelerate reactions by factors of millions.
3. The Michaelis-Menten model describes enzyme kinetics, showing that reaction velocity is determined by the concentration of the enzyme-substrate complex and reaches a maximum velocity (Vmax) as substrate concentration increases. This model is important for understanding how enzymes function.
This document provides an overview of the special senses - pain, vision, hearing and equilibrium, taste and smell. It describes the key components and mechanisms of each sense. For vision, it outlines the structures of the eye, how light is captured and transmitted, and common disorders like cataracts. Regarding hearing, it explains the external, middle and inner ear, how sound is conducted through the ossicles and perceived. It also discusses the vestibular system and conditions like Meniere's disease. Taste and smell are described as chemical senses involving chemoreceptors that influence appetite and provide a quality check for ingestion.
1. The document is a hymn praising God for being present. It expresses how we should feel God's power and bow before His face in silence. We should serve Him with awe and reverence.
2. The hymn notes that angels sing to God day and night, praising Him who is enthroned above all. Though our song is mean, we praise Him with a stammering tongue.
3. It asks that our praise may fill God's courts with grateful fragrance. It expresses the hope that we can still stand before God's face, still hear and do His will, with all our thoughts rising as a ceaseless, accepted sacrifice to Him.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
2. In this module
• What is nutrition assessment?
• Why is nutrition assessment important?
• What is nutrition screening?
• Be able to assess every client's nutritional status, and which clients to
prioritize
3. Cont.
• How often should nutrition assessment be done?
• What are the different kinds of nutrition assessment?
Anthropometric assessment
Biochemical assessment
Clinical assessment
Dietary assessment
• Food security assessment
4. What is nutrition assessment?
• Nutrition assessment includes taking anthropometric measurements and
collecting information about a client’s medical history, clinical and
biochemical characteristics, dietary practices, current treatment, and food
security situation
5. Why is nutrition assessment important?
Optimal nutritional status—the state of the body with respect to each nutrient
and overall body weight and condition—is a powerful factor in promoting
health and preventing and treating diseases. Weight loss of 10 percent or more
has been associated with adverse outcomes and prolonged hospitalization, and
in lean, healthy people, weight loss of more than 35 percent has been
associated with death (Feldman, M.; Friedman, L.; and Brandt, L. 2010 ).
Nutritional status affects immune response and response to medical therapies.
6. Why assess a clients’ nutritional status?
• To identify people at risk of malnutrition for early intervention or referral
before they become malnourished
• To identify malnourished clients for treatment—malnourished people who
are not treated early have longer hospital stays, slower recovery from
infection and complications, and higher morbidity and mortality
• To track child growth
• To identify medical complications that affect the body’s ability to digest food
and utilize nutrients
7. Cont
• To detect practices that can increase the risk of malnutrition and infection
• To inform nutrition education and counseling
• To establish appropriate nutrition care plans
8. Cont.
• The results of a client’s nutrition assessment and classification of nutritional
status determine all the other elements of nutrition assessment, counseling,
and support (NACS) for that individual—including counseling, treatment,
and referral to food security and other support
9. What is nutrition screening?
Full nutrition assessment can be preceded by rapid and simple identification of
people who may be malnourished or at risk of malnutrition and need more
detailed nutrition assessment. Nutritionists and trained facility-based health care
providers or community service providers can do nutrition screening in health
care facilities, during growth monitoring or home-based care, and during
support group meetings.
10. Cont.
Simple nutrition screening can include checking for bilateral pitting edema,
measuring weight and mid-upper arm circumference (MUAC), and asking
about recent illnesses and appetite.
Nutrition screening requires standardized training in line with national health
policy. Special training materials may be needed for low-literacy or illiterate
populations. Community service providers need approved recording and
referral materials, and clear guidance on provider roles, whom to screen, how,
and how often/frequency
11. Who should be prioritized?
• Children under 2 years of age, especially if they are not breastfed
• Women who are pregnant or up to 6 months postpartum
• People who report unintentional weight loss
• People who have been prescribed specialized food products to treat
malnutrition
• People with disease-related symptoms that can be managed through diet
• People with HIV, tuberculosis (TB), or other chronic diseases
12. How often should nutrition assessment be
done?
The frequency of nutrition assessment depends on a client’s age and pregnancy
and disease status and on national policies. The recommendations below should
be adjusted based on national guidelines.
• Pregnant/postpartum women: On every antenatal visit
• Infants 0–< 6 months of age: At birth and on every scheduled postnatal
visit
13. Cont.
• Infants 6–59 months of age: During monthly growth monitoring sessions
for children under 2 and every 3 months for older children
• Children 5 years of age and over: On every clinic visit
• Adolescents and adults: On every clinic visit
• People with HIV: On every clinic visit and when initiating or changing
antiretroviral therapy (ART)
14. What are the different types of nutrition
assessment? ABCD
• ANTHROPOMETRY
Anthropometry is the measurement of the size, weight, and proportions of the
body. Common anthropometric measurements include weight, height, MUAC,
head circumference, and skinfold. Body mass index (BMI) and weight-for-
height are anthropometric measurements presented as indexes
15. Each of these indexes is recorded as a z-score. Z-scores are measured in
standard deviations (SD), and describe how far and in what direction an
individual’s anthropometric measurement deviates from the measurement for a
healthy person of the same age and sex (median). In the bell curve figure, the z-
score for the median (middle) measurement is 0. Z-scores lower than the
median have minus signs (e.g., −1). Z-scores higher than the median have plus
signs or no signs (e.g., +2 or 2).
17. Cont.
• On the number line below, the arrow points in the direction in which the
numbers are getting bigger (to the right of the median) or smaller (to the left
of the median. The further a measurement is from the median (0) on either
side, the greater the risk of malnutrition.
• Whatever measures are used, the same measures should be used every time a
client’s nutritional status is assessed in order to compare results.
18. Weight measurement
Weighing is usually the first step in anthropometric
assessment and a prerequisite for finding weight-
for-height z-score (WHZ) for children and BMI for
adults. Weight is strongly correlated with health
status. Unintentional weight loss can mean poor
health and reduced ability to fight infection.
Weighing requires a functional weighing scale that
measures weight in kg to within the nearest 100g.
19. Cont.
Accurate weight measurement is important because errors can lead to incorrect
classification of nutritional status and the wrong care and treatment.
Low pre-pregnancy weight and inadequate weight gain during pregnancy are
the most significant predictors of intrauterine growth retardation and low birth
weight. To reduce the risk of adverse outcomes, women should enter
pregnancy with a BMI in the normal weight category
20. Recommended pre-pregnancy BMI*
• Pre-pregnancy nutritional status Pre-pregnancy BMI
Underweight Less than 18.5
Normal weight 18.5‒24.9
Overweight 25.0–29.9
Obese 30 or more
21. Cont.
The main anthropometric measurement used for newborns is birth weight,
which is not a measure of acute malnutrition. Infants with low birth weight
(less than 2,500 g) are at higher risk of physical and cognitive impairments and
nutrition-related chronic diseases in later life.
All infants lose weight immediately after birth. This is not a problem unless the
infant loses 10 percent or more of his or her birth weight. Infants should
regain this initial lost weight within 1 week of birth. Most double their birth
weight by the end of the 5th to 6th month
22. Cont.
The most common anthropometric measurements used for infants under 6
months are weight-for-length, weight-for-age, and head circumference. Weight-
for-length is used to measure acute malnutrition, along with other clinical signs
Infants under 6 months should be weighed using a balance beam scale or a
digital UNISCALE that measures infant weight by weighing the mother and
infant together and subtracting the weight of the mother. (TAR)
23. Length and height measurement
Measuring length or height requires a height board or measuring tape marked in
centimeters (cm). Measure length for children under 2 years of age or less than
87 cm long. Measure height for children 2 years and older who are more than
87 cm tall and for adults.
24. Weight-for-height (wasting)
• WHZ is an index that is used to assess the nutritional status of children from
birth to 59 months of age. It compares a child’s weight to the weight of a
child of the same length/height and sex in the WHO Child Growth
Standards to classify the child’s nutritional status. You will need tables with
the WHO Child Growth Standards. There are separate WHO Child Growth
Standards for boys and girls. WHZ can be used for infants under 6 months,
but there are no globally agreed cutoff points for classification of nutritional
status
25. Download for study
The Standardized Monitoring and Assessment of Relief and Transitions
(SMART) Emergency Nutrition Assessment (ENA) tool available from the
NutriSurvey website, calculates WHZ automatically. The SMART training
package is also available online.
26. MUAC measurement
MUAC is the circumference of the left
upper arm measured at the mid-point
between the tip of the shoulder and the
tip of the elbow, using a measuring or
MUAC tape. MUAC measurements in
millimeters (mm) are more accurate than
measurements in cm. MUAC is a proxy
measure of nutrient reserves in muscle
and fat that are unaffected by pregnancy
and independent of height. Use MUAC
to measure all pregnant women and
women up to 6 months postpartum
27. Cont.
MUAC is also an appropriate alternative for measuring children (instead of
WHZ), adolescents (instead of BMI-for-age), and non-pregnant/postpartum
adults whose weight and height cannot be measured (e.g., if they cannot stand
or no equipment is available). MUAC is not currently recommended for infants
under 6 months and should not be used to assess nutritional status in people
with edema
28. MUAC cutoffs to classify nutritional status
in children 6 months to 14 years of age
29. Cont.
Because there are few data on the relationship between MUAC and mortality
and other functional measures in adults, WHO has not established standard
MUAC cutoffs to classify nutritional status in adults.
A Médecins sans Frontières Switzerland review of literature between 1995 and
2012 declared that MUAC is the preferred indicator to identify acute
malnutrition in pregnant women because it is insensitive to changes
30. Cont..
Over the total period of pregnancy. MUAC is easy to measure, and it requires
only one measurement. It has a relatively strong association with low birth
weight, and it does not require knowledge of gestational age. The review found
that in pregnant women, MUAC cutoffs for severe acute (SAM) varied from <
210 mm to < 230 mm in national nutrition protocols. It recommended a
conservative cutoff of < 230 mm for treatment of malnutrition in pregnant
women in Africa and Asia who are at risk of delivering low birth-weight babies
(Ververs, M. et al. 2013. ). The cutoffs below are suggestions based on current
practices
31. BMI
• BMI is an anthropometric indicator based on weight-to-height ratio. It is
used to classify malnutrition in non-pregnant/non-postpartum adults. BMI is
not an accurate indicator of nutritional status in pregnant women or adults
with edema. Use MUAC for these groups.
• Calculate BMI by dividing a person’s weight in kg by the square of the
person’s height in meters. You will have to convert measurements in cm to m
(100 cm = 1 m).
BMI = weight (kg)/ height2 (m)
32. Cont.
• BMI Nutritional status
< 16.0 Severe malnutrition
≥ 16.0 to < 17.0 Moderate malnutrition
≥ 17.0 to < 18.5 Mild malnutrition
≥ 18.5 to < 25.0 Normal nutritional status
≥ 25.0 to < 30.0 Overweight
≥ 30.0 Obesity
********Malnutrition Universal Screening Tool (MUST) ……to determine risk of malnutrition
33. BMI-for-age z-score
BMI can be used to measure the nutritional status of adults over 18 years of
age because they have completed their physical development. Because children
and adolescents are still growing and developing, their age and sex have to be
considered when measuring their nutritional status. BMI-for-age is the
preferred indicator of body thinness to classify malnutrition in children and
adolescents 5–18 years of age.
34. WHO BMI-for-age classifications of malnutrition in
children and adolescents 5−18 years of age.
• BMI-for-age Nutritional status
• < −3 z-score Severe malnutrition
• ≥ −3 and < −2 z-score Moderate malnutrition
• ≥ −2 z-score and ≤ +1 z-score Normal nutritional status
• > +1 and ≤ +2 z-score Overweight
• > +2 z-score Obesity
35. Biochemical Assessment (B)
Biochemical assessment means checking levels of nutrients in a person’s blood,
urine, or stools. Lab test results can give trained medical professionals useful
information about medical problems that may affect appetite or nutritional
status
36. Clinical assessment (C)
• Clinical assessment includes checking for visible signs of nutritional
deficiencies such as bilateral pitting edema, emaciation (a sign of wasting,
which is loss of muscle and fat tissue as a result of low energy intake and/or
nutrient loss from infection), hair loss, and changes in hair color. It also
includes taking a medical history to identify comorbidities with nutritional
implications, opportunistic infections, other medical complications, usage of
medications with nutrition-related side effects, food and drug interactions,
and risk factors for disease (e.g., smoking, alcohol use, overweight) that affect
or are affected by diet and nutritional status
37. Cont.
Assessment of nutritional status in infants under 6 months involves checking
for clinical signs of acute malnutrition such as visible wasting, bilateral pitting
edema, inability to suckle, ineffective breastfeeding, and recent weight loss or
failure to gain weight, as well as risk factors such as insufficient breast milk or
absence of the mother. Clinical assessment for this age group should also
assess infant feeding practices, especially access to breast milk
38. Cont..
Clinical nutrition assessment also includes checking for or asking clients about
symptoms of infection that can increase nutrient needs (e.g., fever) and nutrient
loss (e.g., diarrhea and vomiting), as well as medical conditions (e.g., HIV, celiac
disease) that impair digestion and nutrient absorption and increase the risk of
developing malnutrition. Medical records should provide information about
illness, hospitalizations, operations, diagnostic tests and therapies, and
medications that can affect nutritional status.
39. Note ***
Some medications can interfere with nutrient absorption, digestion,
metabolism, and utilization. Likewise, nutritional status and diet can affect how
medications work. Information about the medications clients are taking allows
health care providers to counsel them on how to manage drug-food
interactions and drug side effects
40. Bilateral pitting edema
Bilateral pitting edema, also called nutritional edema, is swelling in both feet or legs
(bilateral) caused by the accumulation of excess fluid under the skin in the spaces
within tissues. Either too much fluid moves from the blood vessels into the tissues or
not enough fluid moves from the tissues back into the blood vessels. This imbalance
can cause swelling in one or more parts of the body. Bilateral pitting edema is
characterized by pitting in the skin (i.e., a visible indentation that persists after the
pressure is released from skin that has been pressed by a thumb). Edema is a sign of
severe malnutrition ONLY if it exists in both feet or both legs. Other causes of
edema, especially in adults, that are not related to nutrition include congestive heart
disease, lymphatic disorders, and kidney disease, among other conditions
41.
42. Cont.
Bilateral pitting edema is a sign of severe malnutrition on its own, regardless of
the results of anthropometric assessment. Anyone with severe bilateral pitting
edema (Grade +++), even with appetite and no medical complications, should
be admitted for inpatient management of severe acute malnutrition. A person
with bilateral pitting edema Grades + or ++ with appetite and no medical
complications should be treated for severe acute malnutrition on an outpatient
basis
43. Dietary Assessment
Assessing food and fluid intake is an essential part of nutrition assessment. It
provides information on dietary quantity and quality, changes in appetite, food
allergies and intolerance, and reasons for inadequate food intake during or after
illness. The results are compared with recommended intake such as
recommended dietary allowance (RDA)7 to counsel clients on how to improve
their diets to prevent malnutrition or treat conditions affected by food intake
and nutritional status (e.g., cardiovascular disease, cancer, obesity, diabetes, and
hyperlipidemia).
44. How is that done?
• 24-hour recall
This method was designed to quantify the average dietary intake for a group of people,
although it can be used to assess individual nutrition intake. During a recall, a client is
asked to remember in detail every food and drink consumed during the previous 24
hours. The method can be repeated on several occasions to account for day-to-day
variation in intake. Health care providers may prompt clients to remember what they
ate or drank by time periods or activities (e.g., just after waking up, before going to
bed) or to estimate portion sizes by looking at household measures, food models,
household utensils, photographs, or actual food.
45. Food frequency questionnaire
A food frequency questionnaire is designed to obtain information on overall
dietary quality rather than nutrient composition and intake. The food frequency
questionnaire examines how often someone eats certain foods, and sometimes
the size of the portions. This method is quick and inexpensive but under-
reporting is common.
46. Food security assessment
USAID defines food security as “having, at all times, both physical and
economic access to safe and sufficient food to meet dietary needs for a
productive and healthy life.” This definition includes food availability
(sufficient quantities of food available consistently to all people in a country,
region, or household through domestic production, imports, and/or food
assistance), food access (adequate resources to obtain a sufficient quantity and
quality of food), and food utilization/consumption (proper biological use of
food by the body).
47. Food group questionnaire
Another way to do dietary assessment is to show clients pictures of different
food groups and ask whether they ate or drank any of those foods the previous
day.
48. End of module
RESOURCES
• Tumilowicz, Alison. 2010. Guide to Screening for Food and Nutrition Services among Adolescents and Adults Living with
HIV. Washington, DC: Food and Nutrition Technical Assistance II Project (FANTA-2), FHI 360.
• World Health Organization (WHO). 2013. Guideline: Updates on the Management of Severe Acute Malnutrition in
Infants and Children. Geneva: WHO.
• WHO. 1999. Management of Severe Malnutrition: A Manual for Physicians and Other Senior Health Workers. Geneva:
WHO.
• WHO. 1995. Physical Status: The Use and Interpretation of Anthropometry: Report of a WHO Expert Committee.
WHO Technical Report Series 854. Geneva: WHO.