Knowledge update for medical and nutritional undergraduates regarding how to calculate dietary assessment

1. Nutritional Assessment of
Individual and Family,
Nutritional Requirements
Dr. Vinod G. Nikam
Dept. of Community Medicine
D.Y. Patil Medical College, Kolhapur.

2. INTRODUCTION
• Nutritional status of an individual is influenced
by:
- Adequacy of food intake (quality & quantity)
- Physical health of the individual
• Nutritional status of a community is the sum
of the nutritional status of the individuals who
form that community.

3. Objective of Comprehensive Nutritional Survey
• To obtain precise information on the
prevalence and geographic distribution of
nutritional problems of a given community
• Identification of individuals or population
groups “at risk” or in greatest need of
assistance

4. RECOMMENDED DIETARY ALLOWANCE (RDA)
• The average daily dietary nutrient intake level
sufficient to meet the nutrient requirement of
nearly all (97-98%) healthy individuals in a
particular life stage and gender group.

5. ASSESSMENT OF NUTRITIONAL STATUS
• Purpose : To develop healthcare programme to meet the needs
Evaluation of the effectiveness of such programmes
• Process: Examination of random and representative sample of
population
All ages, both sexes in different socio-economic
groups
Drawing valid conclusions
Survey – Duration , Type (Cross/ Longitudinal)
Measurement techniques & Instruments

6. ASSESSMENT METHODS
1) Clinical examination – Signs ( WHO expert committee )
a) Not related to nutrition – Alopecia, Pyorrhea, pterygium
b) That need further investigations - Molar pigmentation,
Corneal vascularisation, geographic tongue
c) Non to be value – Angular steatites, Bigots spots, calf
tenderness, Absence knee / ankle jerks ( Beri-beri ),
Enlargement of thyroid gland ( Endemic goiter )
2) Anthropometry – Recorded over a period of time
3) Biochemical Assessment – Hb , Urine – Albumin / Sugar
4) Functional indicators – Prothrombin time , Sperm count, Heart rate.

7. Assessment Methods – ( Cont )
5) Assessment of dietary intake:
i) Weighment of raw foods
ii) Weighment of cooked foods
iii) Oral questionnaire Method
6) Vital and Health statistics: Mortality & Morbidity
7) Assessment of Ecological factors:
a) Food balance sheet
b) Socio economic factors – family size , occupation, income,
education, customs,
c) Health and education services
d) Conditioning influences
i. Parasitic infestation
ii. Bacterial & viral infections

8. Oral Questionnaire Method
• Useful in carrying out a diet survey of a large
number of people in a short time.
• Inquiries about the nature and quantity of
foods eaten during the previous 24 or 8 hours
retrospectively.

9. Dietary Assessment
• Data collected from a diet survey has to be
translated into
• Mean intake (grams) of food in terms of
cereals, pulses, vegetables, fruits, milk, meat,
fish, eggs.
• The mean intake of nutrients of nutrients per
adult man value or “consumption unit”

10. Dietary Survey
• Diet survey provides information about dietary
intake patterns, specific foods consumed and
estimated nutrient intakes.
• It indicates relative dietary inadequacies as
judged by present standards.
• Provides valuable information for planning
health education activities as well as extent and
nature of changes needed in the agriculture and
food production industries.

12. Nutritive Value of Cereals & Millets per 100 grams
Cereals
&
Millets
Protein
(g)
Fat
(g)
Calcium
(g)
Fiber
(g)
Energy
(kcal)
Rice (raw) 6.8 0.5 10 0.2 345
Rice
(parboiled)
8.5 0.6 10 0.2 349
Wheat 11.8 1.5 41 1.2 346
Maida 11.0 0.9 23 0.3 348
Bajra 11.6 5.0 42 1.2 361
Jowar 10.4 1.9 25 1.6 349
Ragi 7.3 1.3 344 3.6 328

13. Nutritive Value of Pulses per 100 grams
Pulses Protein
(g)
Fat
(g)
Calcium
(mg)
Iron
(mg)
Energy
(kcal)
Bengal gram 17.1 5.3 202 4.6 360
Black gram 24.0 1.4 154 3.8 347
Red gram 22.3 1.7 73 2.7 335
Soyabean 43.2 19.5 240 10.4 432
Green gram 24.5 1.2 75 3.9 348
Groundnut 25.3 40.1 90 2.5 567

14. Nutritive Value of Milks per 100 grams
Milk
Protein
(g)
Fat
(g)
Calcium
(mg)
Iron
(mg)
Energy
(kcal)
Buffalo 4.3 6.5 210 0.2 117
Cow 3.2 4.1 120 0.2 67
Goat 3.3 4.5 170 0.3 72
Human 1.1 3.4 28 0.5 65

15. Nutritive Value of Foods per 100 grams
Foods Proteins (g) Fat (g) Energy (kcal)
Meat 21.4 3.6 200
Fish 19.5 2.4 87
Egg (Hen) 13.3 13.3 173
Oil & Ghee - 100 900
Sugar 0.1 0 400
Jaggery 0.4 0 383
Banana 1.2 0.3 116

16. TYPE OF WORKER AND OCCUPATION
Type of Worker Occupation
Sedentary worker Teacher, Doctor, Engineer, Lawyer, Priest, Retired
personnel, Executive, Clerk, Bank manager, Nurse,
Shopkeeper, Landlord, Peon, Postman, Security guard,
Tailor, Hair dresser, Shoemaker, Housewife
Moderate worker Fisherman, Potter, Fitter, Turner, Driver, Welder,
Weaver, Carpenter, Rickshaw puller, Beedi maker,
Basket maker, Electrician, Mason, Servant-maid,
Industrial labourer, Agriculture labourer, Coolie,
Goldsmith
Hard worker Blacksmith, Stonecutter, Woodcutter, Mineworker,
Gang man

17. Dietary Coefficients of Individuals
Group Coefficients (Units)
Adult male (Sedentary worker) 1.0
Adult male (Moderate worker) 1.2
Adult male (Heavy worker) 1.6
Adult female (Sedentary worker) 0.8
Adult female (Moderate worker) 0.9
Adult female (Heavy worker) 1.2
Adolescents 10 to 19 years 1.0
Children 9 to 12 years 0.8
Children 7 to 9 years 0.7
Children 5 to 7 years 0.6
Children 3 to 5 years 0.5

18. Dietary Assessment
Any individuals dietary assessment is calculated
based on Energy Consumption Units(ECU),
which is 2400.
ECU X Dietary Coefficient (DU) (according to the Type
of work & Gender) gives the Dietary requirement of an
individual
For e.g. A Doctor’s dietary requirement is 2400 x 1 = 2400

19. Dietary Assessment
Consider a family consisting of 4 members
Their Dietary intake on 02/06/2021 is
 Breakfast : Poha & 4 cups of tea
 Lunch: 7 Chapatti's, Rice, Dhal & Sabji
 Evening : 4 cups of tea & 1 packet Parle G biscuit
 Dinner: 7 Chapatti's, Rice, Dhal & Sabji
Member Age in years Occupation Type of work Weight in kg
Father 48 Teacher Sedentary 62
Mother 43 Housewife Sedentary 50
Son 22 Student Sedentary 55
Daughter 15 Student Sedentary 38

20. Diet history of family members consumed food in last 24 hrs
Menu Ingredients Calorie Calories Protein
BREAKFAST
POHA Rice flakes: 1 big vati(100gms)
Oil -15ml,
Groundnuts: 10grams
01 x 345
0.15 x 900
0.1 567
345
135
57
6.8
-
2.5
TEA 4 cups Milk: 200ml
Sugar: 20grams
02 x 117
0.2 x 400
234
80
8.6
LUNCH
Chapatti
Rice
Dhal
Sabji
7 Big Chapatti's made of 35gms wheat
flour each
1 small vati raw Rice (150gms)
Dhal ½ vati (50gms)
Vegetables 200gms
7 x 35 = 245
2.45 x 346
1.5 x 345
0.5 x 340
02 x 100
848
518
170
200
28.9
10.2
11
-
EVENING SNACK
TEA 4 cups &
15 Biscuits
Milk: 200ml
Sugar: 20gms
Biscuits: 75gms
02 x 117
0.2 x 400
234
80
462
8.6
-
6.7
DINNER
Chapatti
Rice
Dhal
Sabji
7 Big Chapatti's made of 35gms wheat
flour each
1 small vati raw Rice (150gms)
Dhal ½ vati (50gms)
Vegetables 200gms
7 x 35 = 245
2.45 x 346
1.5 x 345
0.5 x 340
02 x 100
848
518
170
200
28.9
10.2
11
-
Total 5099 133.4

21. Required Calories & Proteins
Member Type of
work
ECU DU DA= ECU x DU Protein
Requirement
(1gm/kg wt)
Father Sedentary 2400 1.0 2400 62
Mother Sedentary 2400 0.8 1920 50
Son Sedentary 2400 1.0 2400 55
Daughter Sedentary 2400
1.0 2400 38
Total 9120 205

22. Dietary Assessment
• Total Consumption Units: 9120
• Energy Consumption/Unit: 9120/4 = 2280
Diet Calories Proteins
Required 9120 205
Intake 5099 133.4
Deficient 4021 71.6