This document discusses various methods for nutritional assessment, including anthropometric, biochemical, clinical, dietary, functional, and anthropometric assessments. It provides details on each method, including what they measure and their advantages and limitations. The key methods covered are anthropometry (measuring height, weight, skin folds), biochemical tests of nutrients, clinical exams for signs of deficiencies, dietary assessments like 24-hour recalls, and functional tests of physiological processes impacted by nutrition.

1. Nutritional Assessment
(Method, Clinical, Biochemical, Dietary, Functional and Anthropometric)
Dr. Rajan Bikram Rayamajhi
School of Public Health and Community Medicine
B. P. Koirala Institute of Health Sciences
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Dharan, Nepal

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3. The nutritional status of an individual if often the
result of interrelated factors. It is influenced by
the adequacy of the food intake both in terms of
quantity and quality and also by the physical
health of the individual.
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4. Nutritional Assessment Methods:
1. Anthropometry A
2. Biochemical Evaluation B
3. Clinical Examination C
4. Dietary Assessment D
5. Ecological Studies E
6. Functional Assessment F
7. Vital and Health Statistics G
*Pneumonics
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5. Clinical Examination
 To assess levels of health of individuals or of
groups in relation to the food they consume.
 Simple, easy and most practical.
 Physical signs: some specific and many non-
specific associated with malnutrition.
 Ex: Angular Stomatitis, Bitot’s Spot, Thyroid
enlargement
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7.  The chief drawbacks are many deficiencies are
unaccompanied by physical signs, malnutrition
cannot be quantified on the basis of clinical signs
and biasness of the observer and observed.
 When two or more nut. deficiency signs are
present, the diagnostic significance is enhanced.
 The drawback are mal nut. can’t be identified
only on the basis of clinical signs and lack of
specificity of most signs.
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8. Anthropometry
 Height, weight, skin fold thickness and arm
circumference are valuable indicators of
nutritional status.
 In young children chest and head circumference
are measured too.
 If recordings are made for a long time then they
reflect the pattern of growth and development.
 Ex: Mid arm circumference, Growth monitoring
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10. Laboratory and Biochemical Evaluation
I. Lab Tests:-
i) Haemoglobin, RBC, Haemotocrit
Hb level is an useful index of the overall state of
nutrition irrespective of its significance in
anemia.
ii)Stool : for intestinal parasites, history of parasitic
infestation, chronic dysentery
iii) Urine: for albumin and sugar
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11. II. Biochemical Tests:-
– Expensive and time consuming.
– They reveal current nutritional status.
– Some of the test are protein, Folate, vitamin A and
Niacin
With increase knowledge of metabolic functions of
vitamins and minerals, assessment of nutritional
status by clinical signs has been given to more
precise biochemical tests.
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12. Radiological Examination
• Routinely not carried out.
• If the clinical signs indicate appreciable
incidence of rickets, osteomalacia, infantile
scurvy, beriberi, fluorosis and PCM then only
such tests are carried out.
• Such study will reveal the degree of incidence
of mild forms.
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14. Functional Assessment
• The main purpose of these tests are to assess
the degree of alteration in physiological
functions associated with under and
malnutrition
• Functional indices of nutritional status are
emerging as an important class of diagnostic
tools
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15. Reproduction
(Sperm Count) Energy, Zinc
Nerve Function
Nerve conduction Vit. B1,Vit. B12
Dark adaptation Vit. A , Zinc
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16. Assessment of Dietary Intake
• Food Consumption: 24 hour food frequency and
household inquiries.
• Dietary survey: Household inquiries or Individual
food consumption which includes :
weighing of raw food:
It’s practicable and if properly carried our is fairly
accurate.
All food that is eaten or discarded is also weighed.
Usually carried out for 1-21 days but commonly done for
7 days; also called one dietary cycle.
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17. Nutrition Assessment
Consumption amount in Calories Protein
Name of food stuffs
24 hours (kcal) (gm)
Rice 1500gm 5250 102
Pulses 250gm 837 50
Potato 50gm 50 -
Root vegetables 50gm 15 -
Leafy vegetables 500gm - -
Other vegetables 1000gm - -
Fats and oil 10tsp 450 -
Milk/dairy product 500ml 350 20
Meat 1000gm 1000 200
Sugar and jaggery 50gm 200 -
Total 8152 372

18. Weighing of cooked food:
The food is to be analysed in the state they are to
be eaten and not easily acceptable.
Oral questionnaire method:
Diet survey done in a short time among large no.
of people.
Inquiries are made about the last 24 hrs
retrospectively.
Data is also collected about dietary habits and
practices.
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19.  Data collected is translated into mean intake of food
materials and nutrients per adult man value or
“consumption unit”
 Diet survey gives dietary intake patterns, specific
food consumed, nutrient intake.
 It also indicates relative dietary inadequacies as
judged by the present standards.
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20. Vital and health statistics
Analysis of mortality and morbidity data will
identify groups at high risk and indicate the
extent of risk to the community.
 Mortality in age grp. 1—4 yrs. related to
malnutrition.
Data on morbidity ( Hospital data or data from
community ) in relation to PEM, anemia,
xeropthalmia can be of value to provide
additional information about the nutritional
status of the community
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21. Ecological Studies
Food Balance Sheet:
 Supplies are related to census population to
derive levels of food consumption in terms of
per capita supply availability.
It gives an indication of the general pattern of
food consumption in the country
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22. Health and Education Services:
Primary health care services, feeding and
immunization program.
Conditioning Influences:
Parasitic, bacterial & viral infections which
precipitate mal-nutrition among that
community.
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23. Socio-Economic Factors:
 Family size, occupation, income, education customs,
cultural patterns in relation to feeding practice of
children, mother etc.
 Food consumption patterns are likely to vary among
various socioeconomic group.
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24. Thank You
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