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.

1. Nutritional Status
Assessement ABCD Methods
Dr. Vaishali Soni
PhD. (Food and Nutrition)

2. •Nutritional status of an Individual is result of many inter-related
factors -food intake, physical activity , genetic factors etc
•Spectrum of nutritional status vary from severe malnutrition to
obesity

3. OUTLINE OF PRESENTATION
 Introduction
 Nutritional Assessment
 Anthropometric Measurement
 Biochemical Assessment
 Clinical Assessment
 Dietary Assessment
 Functional Assessment
 Radiological Assessement
 Summary

4. INTRODUCTION
 The nutritional status of an individual is often the result of many inter-
related factors.
 It is influenced by food intake, quantity & quality, and physical health.
 The spectrum of nutritional status spreads from severe malnutrition
to obesity.

5. People can have an optimal nutritional status or
they can be under , over and/or malnourished .
Severe underweight
(Under-nourished)
Healthy baby
(Optimal nutritional status)
Morbid Obesity
(Over-nourished)

6. INTRODUCTION
 The nutritional status of an individual is often the result of many inter-related
factors.
 The spectrum of nutritional malnutrition(FAO- 460 million which contributes
about 15% of world population excluding china)
 Of which 300million falls under south asia
 Identify individuals or population groups at risk of becoming malnourished
 Todevelop health care programs that meet the community needs which are
defined by the assessment
 T
o measure the effectiveness of the nutritional programs & intervention
once initiated

7. Undernourished people in the world:
859,118,114
 India
 Undernourished people - 194,400,000
 Percent - 14.37%
 Population,2018 - 1,352,642,280
Ref. -https://www.worldometers.info/undernourishment/

8. Indicators to assess and analyse nutrition
In the Triple-A Cycle model:
ASSESSMENT of the nutritional
situation in target
population
ACTION
based on the analysis &
available
resources
ANALYSIS
of the causes
of the problem
The ASSESSMENT stage
aims to
define the nutritional
problem in
terms of magnitude and
distribution.
The ANALYSIS stage
aims to
analyse the causes of
malnutrition

9. Relationship of nutrition with other elements

10. What is nutrition assessment?
Nutrition assessment includes taking anthropometric measurements
and collecting information about a person’s medical history, clinical
and biochemical characteristics, dietary practices, current
treatment, and food security situation.

11. Nutritional Assessment - Why?
The purpose of nutritional assessment is to:
 Identify individuals or population groups at risk of becoming
malnourished.
 Identify individuals or population groups who are malnourished.
 To develop nutrition and health care programs that meet the community
needs which are defined by the assessment.
 To measure the effectiveness of the nutritional programs & intervention
once initiated.

12. METHODS of Nutritional Assessment
Direct –
deal with the individuals and measure the objective criteria
Indirect –
use community health indices that reflect nutritional influences

13. DIRECT METHODS OF NUTRITIONAL
ASSESSMENT
 Anthropometric methods
 Biochemical, laboratory methods
 Clinical methods
 Functional assessment
 Radiological examination

14. INDIRECT METHODS OF NUTRITIONAL
ASSESSMENT
 Dietary assessment
 Ecological variables including crop production
 Economic factors e.g. per capita income, population
density & social habits
 Vital health statistics ,infant & under 5 mortality &
fertility index

15. Assessing Nutritional Status
Nutritional status can be assessed through:
Body (anthropometric) measurements, used to measure
growth in children and body weight changes in adults.
Clinical examination, biochemical testing and dietary
Assessment used to diagnose deficiencies of micronutrients
(e.g. iodine, vitamin A and iron).

16. Anthropometry
Anthropometry is the most frequently used method to assess nutritional status.
It is precise and accurate; relatively quick, simple, and cheap means of nutritional
assessment.
It uses standardized technique;
It is suitable for large sample sizes, such as representative population
samples;
It does not require expensive equipment, and skills can be learnt quickly.
Anthropometry is a study of the measurement of the dimensions of bone, muscle and
adipose tissue of the human body.

17. ANTHROPOMETRIC METHODS
 It is an essential features of all nutritional surveys
 It is the simplest & most practical method
 It utilizes a number of physical signs, (specific & non specific),
associated with malnutrition and deficiency of vitamins &
micronutrients

18. Anthropometric measurements
• Length/Heigh Weight
• Weight
• Mid-arm circumference
• Skin fold thickness
• Head circumference
• Head/chest ratio
• Hip/waist ratio

19. Other anthropometric Measurements
• Mid-arm circumference
• Skin fold thickness
• Head circumference
• Head/Chest ratio
• Hip /Waist ratio

20. ANTHROPOMETRY FOR CHILDREN
 Accurate measurement of height and weight is essential. The
results can then be used to evaluate the physical growth of the
child.
 For growth monitoring the data are plotted on growth charts
over a period of time that is enough to calculate growth
velocity, which can then be compared to international
standards

21. Height measurement
 The subject stand erect on stadiometer.
 The movable head piece is leveled with head vault Height is recorded to nearest
0.5 cm.
 For infants infantometer is used.
 Growth monitoring of a child by comparing with international/ national standards
using growth charts over a period of time.

22. LENGTH MEASUREMENT

23. HEIGHT MEASUREMENT
(STANDING)

24. Correct Head Position Incorrect Position

25. WEIGHT MEASUREMENT

26. WEIGHT MEASUREMENT UNDER YEARS

27. Weight
For Individual child , if repeated it helps in identifying growth
faltering & early identification of malnutrition
Classified as normal, underweight, moderately underweight ,
severely underweight , overweight , obese

28. WEIGHT
WEIGHING IS MOST COMMONLY USED ANTHROPOMETRIC MESUREMENT USED
FOR ASSESSING NUTRITIONAL STATUS

29. Children who must be held by
an adult while on the scale
 Press the “START” key with no load on the scale and wait until the
display “0.00” appears.
 Ask the adult wearing light clothing and no shoes to step onto the
center of the scale without the child and stand quietly with legs
slightly apart. Wait until the numbers (weight of the adult) on the
display no longer change and stay fixed in the display.
 Press the 2 in 1 key to activate the function. The scale stores the
weight of the adult and the display returns to zero. “0.00” and “NET”
appear in the display.

30. Children who must be held by
an adult while on the scale
 Give the child wearing light clothing and no shoes to the adult.
The scale determines the weight of the child. Once the value is
stable for about 3 seconds, the display is retained. This avoids the
display jumping about as a result of the child’s movements.
“HOLD” and “NET” appear in the display.
 Record the weight of the child to 0.01 kg (i.e., 10 g) on the
questionnaire.

33. Mid-upper arm circumference(MUAC)
 Mid-upper arm circumference (MUAC) measures the muscle mass of the upper
arm.
 Measured on the left arm.
 A flexible measuring tape is wrapped around the mid-upper arm (between the
shoulder and elbow) to measure its circumference.
 MUAC should be measured to the nearest 0.1cm.
 MUAC is a rapid and effective predictor of risk of death in children aged 6 to 59
months and is increasingly being used to assess adult nutritional status.

34. MEASURING MID ARM CIRCUMFERENCE

35. Steps of Taking Measurements
1. Position the Subject: The right arm bent 90⁰at the elbow,
and the right palm facing up.
1. Mark the measurement site
2. Take the measurement to the nearest 0.1 cm
3. Mark the midpoint horizontally
4. Record the result

37. Common Errors

38. Skin-fold thickness
 Skin fold calipers are used (Harpenden and Lange)
 Measures the thickness of the
 Skin and subcutaneous fat using constant pressure applied over a known area
 Common sites: triceps and in the sub-scapular region
 It has value in assessing the amount of fat and therefore the reserve of energy in the body

39. Waist/hip ratio
Waist measurement
 Measured at the level of umbilicus nearest to 0.5cm
 Subject stands erect with relaxed abdominal muscles, arms at the side and feet together
 Measurement taken at the normal expiration
Hip measurement
 Measured at the point of greatest circumference around hips to nearest 0.5cm
 Close contact with the skin without indenting the soft-tissues
 Subject should be standing and measurer beside him.
Interpretation of WHR
 High-risk WHR=>0.8 in females and =>0.95 in males indicates central obesity and considered high-
risk for diabetes and cvs disorders.

40. Equipment Care and Maintenance
 Proper care for the scale and length/height boards is important to
ensure that measurements are as accurate as possible.
 The accuracy of equipment should be checked at the time of
purchase.
 Clean the white area of the infantometer with bleach disinfectant
spray.
 Clean the digital measurement device of the height board and
infantometer with a dry cloth.
 Check that the head/foot piece of the height board and
infantometer slides smoothly along the measurement column.

41. Advantages of anthropometry
Objective with high specificity & sensitivity
Measures many variables of nutritional significance (Ht, Wt, MAC, HC, skin fold thickness,
waist & hip ratio & BMI).
Readings are reproducable numerical & gradable on standard growth charts Non-expensive &
need minimal training
Limitations of Anthropometry
Inter-observers errors in measurement
Limited nutritional diagnosis
Problems with reference standards, i.e. local versus international standards.
Arbitrary statistical cut-off levels for what considered as abnormal values.

42. Four main data collection methodologies
that provide anthropometric information are :
Repeated Surveys
Growth Monitoring
Sentinel Site Surveillance
School Census Data
Anthropometry
Two major sources of anthropometric information are:
Demographic and Health Surveys (DHS)
Multiple Indicator Cluster Survey (MICS)

43.  Hemoglobin estimation is the most important test, & useful index of the overall state of
nutrition. Beside anemia it also tells about protein & trace element nutrition.
 Stool examination for the presence of ova and/or intestinal parasites
 Urine dipstick & microscopy for albumin, sugar and blood
 Measurement of individual nutrient in body fluids (e.g. serum retinol, serum iron, urinary
iodine, vitamin D)
 Detection of abnormal amount of metabolites in the urine (e.g. urinary
creatinine/hydroxyproline ratio)
 Analysis of hair, nails & skin formicro-nutrients
BIO- CHEMICAL &LABORATORY ASSESSMENT

44. INITIAL LABORATORY ASSESSMENT
1. Haemoglobin estimation
 most important test when accurately measured, tells about overall state of nutrition
(anemia, and also protein and trace element nutrition)
 Blood is collected from a finger, ear lobe or heel prick
 Haemoglobinometres which are simple, cheap and reasonably accurate are used

45. INITIAL LABORATORY ASSESSMENT
2. Haematocrit or packed cell volume (PCV)
 percentage of the blood volume composed of red cells.
 important in the diagnosis of anemia.
3. Red cell counts and blood films
 the size and uniformity of the red blood cells canbe seen.
 Use of such slides may facilitate the diagnosis of malaria and the haemoglobinopathies.
 Parasites if present can be seen.

46. INITIAL LABORATORY ASSESSMENT
4. Stool examination
 For presence of ova and/ or intestinal parasites
 When assessed quantitatively parasite load can be known
5. Urine examination
 Dipstick and microscopy for albumin, sugar and blood

47. SPECIFIC LAB TESTS
6. Measurement of nutrients in body fluids
 e.g. serum retinol, serum iron
7. Measurement of abnormal metabolites
 e.g. urinary iodide, urinary creatinine/ hydroxyapatite ratio

48. Advantages
 Useful in detecting early changes in body metabolism and nutrition
 precise , accurate and reproducible.
 Useful to validate data obtained from dietary methods e.g. comparing salt intake
with 24-hour urinary excretion.

49. Limitations of biochemical & laboratory
methods
 Time consuming and expensive
 Cannot be applied on large scale
 Reveal only current nutritional status

50. What is clinical assessment of
nutrition?
 Clinical assessment – estimation of nutritional status on the basis of recording a
medical history and conducting a physical examination to detect signs
(observations made by a qualified observer) and symptoms (manifestations
reported by the patient) associated with malnutrition.
Clinical Assessment

51. Clinical methods
 Essential feature of all nutritional surveys
 Simplest and most practical method
 Utilizes a number of physical signs (specific and non-specific) that are known to be
associated with malnutrition and deficiency of vitamins and other micro-nutrients.
 General Clinical examination with special attention to organs like hair, angles of mouth,
gums, nails, skin, eyes, tongue, muscles, bones & thyroid gland.
 Detection of relevant signs helps in establishing the nutritional diagnosis.

52. Clinical Signs Nutritional abnormality
1.Hair
Spare and thin
Protein, Zinc, Biotin,
deficiency
Easy to pull out Protein deficiency
Cock-screw
coiled
Vit A and Vit C deficiency
Depigmentation Protein deficiency
2. Mouth
Bleeding and
spongy gums
Deficiency of
Vit C, A, K, Folic acid, Niacin
Glossitis ,
Cheililitis
Deficiency of
Riboflavin, Niacin, Folic acid, B12 and proteins.
2. Mouth
Angular stomatitis, cheilosis and fissured tongue
B2, 6 & Niacin deficiency
Clinical signs of nutritional deficiencies

53. Clinical Signs Nutritional abnormality
Leukoplakia Vit A, B12, Bcomplex, Folic acid and Niacin deficiency
3. Eyes
Xerosis of conjunctiva or Xerophthalmia
First clinical sign
Vit A deficiency
Bitots spots Moderate deficiency of Vit A deficiency
Corneal ulceration and keratomalacia Severe Vit a deficiency – medical emergency
Night blindness, photophobia, blurring of vision Vit A and Vit B2 deficiency
4. Nails
Spooning of nails
Iron deficiency
Transverse lines Protein deficiency
5. Glands
Goiter
Iodine deficiency
6. Skeletal system
Beading of ribs (rickety rosary), bow legs
Vit D deficiency

54. Clinical Assessment
 Advantages
• It is useful in detecting early changes in body metabolism &
nutrition before the appearance of overt clinical signs.
• It is precise, accurate and reproducible
 .
• Useful to validate data obtained from dietary methods e.g.
comparing salt intake with 24-hour urinary excretion.
 Disadvantages
• Time consuming
• Expensive
• They cannot be applied on large scale
• Needs trained personnel & facilities

55. DIETARY
ASSESSMENT

56. WHAT IS DIETARY
ASSESSMENTS
 Dietary assessments are comprehensive evaluation to assess food consumption at
national level, household level and a person’s food intake level.
 It is one of the tool for nutritional status assessment.
 It includes :
 Food supply
 Production at national level
 Food purchase at the household level
 Food consumption at individual level

57. Methods of Dietary Assessment

58. DIETARY ASSESSMENT
 Nutritional intake of humans is assessed by five
different methods. These are:
 24 hours dietary recall
 Food frequency questionnaire
 Dietary history since early life
 Food dairy technique
 Observed food consumption

59. FOOD BALANCE SHEET METHOD
 Used when information regarding availability and consumption of
food is required at a macro level like at the global, national, region or
state levels.
 Maintained by each country.
 indicates the total food available in the country along with buffer
stocks.
 FAO monitors at international level since 1949

60. FOOD BALANCE SHEET METHOD
 Gives the estimate of available food in the country per person per year or per
day.
 The total food supplies available and used up at a given level are taken into
account in this method.
 Effectively the difference between receipt ( of food ) and expenditure over a given
period of time gives the food consumed by population.

61. FOOD BALANCE SHEET METHOD
Per person per
day of food
availability
Beginning of the year
stock + total food -
produced + imports
Stock at the end of
the year+ exports + seeds+
cattle/poultry feeds + wastage
Total mid year population * 365 days
=

62. FOOD BALANCE SHEET METHOD
ADVANTAGES :
 Inexpensive source of indirect nutrition data, standardized, accessible
by all, relatively simple to analyze
 Include nearly all countries worldwide
 Monitor global nutrition patterns and dietary habits, including trends
and changes in overall national food availability
 Helps national planners to take appropriate decision to avert “food
crisis”.

63. FOOD BALANCE SHEET METHOD
DISADVANTAGES
 Cannot provide disaggregated information across different population
characteristics, e.g. socio-economic, demographic etc.
 Do not provide data on seasonal variations in the food supply
 Do not provide individual-based dietary estimates
 Food waste (domestic and retail), processed foods, home grown food
production and food from non-retail sources are not accounted for

64. INVENTORY METHOD

65. INVENTORY METHOD
 Carried out at an institutional level, on a homogenous group as present in
a hostel, jails, mess, army barrack, orphanage etc.
 It is essentially done from books.
 Log book method / food list method
 Actual amount of food stuff issued by the in-charge of institute are taken
into account for consumption.
 Purchased / discarded food is taken into account.
 METHOD : two visits by investigators.
 one at the beginning – checklist of food stocks is prepared and handed over to in-charge.
 Second at the end of a week

66. FOOD BALANCE SHEET METHOD
Average intake of
food/person/day =
Stock at Beginning of Week
-
- Stock at the end of Week
Total inmates participating in mealx no. of days of
survey

67. Advantage and Disadvantage
 Advantage
 Covers large area in short time.
 It is fast, much easier,less
cumbersome and faster than the
weighment methods.
 It is also fairly accurate. It may not
indicate an accurate individual food
consumption but fairly satisfactory
for the purpose of planning.
 Disadvantage
 Gives the estimate of food available rather than food consumed.
 It doesn’t acount for wastage.
 It gives only the mean individual consumption but actual individual consumption is
not reflected.

68. WEIGHT METHOD

69. WEIGHT METHOD
 In this method the foods are actually weighed using a grocer’s balance.
 Both raw and cooked food are weighed.
 In community Survey (at a family level), the raw food is weighed rather than the
cooked food, since weighing coo food is not acceptable to the families.
 In an institution however, the cooked food can also be weighed, since cooking is
carried out at a central kitchen.

70. While using weighment method at a family level
the following points are important:
 1. Convince the house wife of the need of the survey for the benefit of the family.
 2. Avoid holidays/ fares/ festivals as the dietary practice of these does not reflect
the actual dietary practie.
 3. It should be carried out for 3 to 7 days consecutively.
 4. At least two visits a day for lunch and dinner have to be made.
 5. Two investingators should be available- one talks and weighs and the other
records observations.
 6. Any pets, breast fed children, guests etc. should be considered.

71. Advantages
 More accurthan 24 hr recall.
 Good to estimate caloric intake.
 It accounts for the non edible part of food as well. The wastage is also taken into
account.
Disadvantages
 Time consuming
 Uncooperating from family
 Applicability to other nutrients like Proteins, Vitamins is limited.
 Can be adopted in institution/hospitals.

72. 24 HOUR RECALL
METHOD

73. 24 HOURS DIETARY RECALL
A trained interviewer asks the
subject to recall all food & drink
taken in the previous 24 hours.
It is quick, easy, & depends on
short-term memory, but may not
be truly representative of the
person’s usual intake

74. Contd...
 Enlist all the family members who partook the
meals yesterday.
 The completed age(in years for adults, in months
for infants and young children).
 Their physiological status( pregnancy, lactation)
 Occupation- Sedentary, Moderate, Heavy.
 Economic status. This helps to arrive adult
consumption units.

75. Contd...
 Housewife's/ individual is asked which food and what amounts were consumed on
previous day or yesterday
 Avoid 3 F
1. Festival
2. Fast
3. Feast days

76. 24 HOUR RECALL METHOD
 An account of raw ingredients used for each of the preparations is
obtained with the help of grocer’s balance
 Information on total cooked amount of each preparation is noted in terms
of standardized cups.

77. Example

80. Example of 24 hr recall method
Diet of a 28 years old sedentary female weighing 56 kgs

81. ITEMS
(Amount)
TOTAL CALORIES (kcal)
PROTEIN
(g)
CALCIUM
(mg)
Morning
BF
(10.30
am)
2 chapati with
ghee+1 cup tea
2*30=60gm wheat +
5ml ghee, 75 ml
buffalo milk + 1 tsf
=5g sugar
=210+45+87+20
=362
=7.2+3.4
=7.6
17.4+157.5
=174.9
Lunch
(1:00
pm)
3 chapati with
ghee+ 1 bowl
(200ml) Aloo
sabzi with 1 tsf
ghee
3*30=90gm wheat +
7.5ml ghee +150g
potato+ 5ml oil+5ml
ghee
=315+67.5+150+
45+45
= 622.5
=10.8+2.4
=13.2
26.1
Evening
(4:00pm
1 cup tea + 4
parle-G biscuits
75 ml buffalo milk +1
tsf = 5g sugar + 4
biscuits
=87+ 20+ 63.6
= 170.6
=3.2 +
biscuit pr
157.5
Dinner 2 chapati with
ghee+ 1
bowl(200ml)
Moong dal+ 1
glass milk + 2 tsp
sugar
2*30=60gm wheat +
5ml ghee+ 50g dal + 5
ml oil+ 250 ml
buffalo milk + 10 g
sugar
=210+45+174+45
+ 292.5+40
=806.5
= 7.2+
12.3+10.8
=30.3
17.4+37.5+5
25
=579.9
Total = 1961.6 (1900)
excess = 61.6
= 57.3 (58)
Deficit=0.3
938.4 (600)
excess=
338.4

82. 24 HOUR RECALL METHOD
ADVANTAGES
 Low respondent burden
 Easy in administration
 Minimum of biases associated with altering food intake because of
knowledge that one is being observed.
DISADVANTAGES
 Forgetting
 Deliberate misreporting
 Need for a trained observer to administer
 Costs associated with computerized analysis of records
 Need for several days of intake to estimate usual diet

83. DIETARY SCORE
METHOD

84. DIETARY SCORE METHOD
Assign arbitrary score to the food on the basis
of its nutrient content.
Consumption of the particular food is estimated
through frequency method
Frequency of consumption of foods, the total
score and percentages are calculated.
Better value if combined with quantitative
methods.

85. FOOD FREQUENCY
QUESTIONNARIE METHOD

86. FOOD FREQUENCY
QUESTIONNARIE
 Based on principle as to how frequently an item is
consumed over a period of time.
 A retrospective review of intake frequency that is food
consumed per day, week, per 15 days, per month.
 Report usual frequency of consumption of each food item
from a list of food items in reference to a specified period
(past week/ month/ year)

87. FOOD FREQUENCY QUESTIONNARIE
Organizes foods into groups that have
common nutrients.
Face to face interview, telephone or by self
administration.
Describes dietary patterns or food habits not
nutrient intake.
Semi qualified tools can obtain information
on portion size using household measures.

90. FOOD FREQUENCY QUESTIONNARIE
LIMITATIONS
Relies on memory
Require complex calculations to estimate
frequencies
Requires literacy
Does not quantify intake
Questionnaires need to be adapted and validated
to reflect the study population and purpose.
Not suitable for a population where people
have distinctly different dietary patterns.

91. DUPLICATE SAMPLES METHOD

92. DUPLICATE SAMPLES METHOD
Chemical analysis
What is consumed in the family, the same
amount of each food item is kept separately
per day as a duplicate sample
These samples can be weighed and also
sent to lab for analysis of nutrients
ADVANTAGE : Most accurate method
DISADVANTAGE : Costly method, needs
good laboratory support

93. EXPEDITURE PATTERN
METHOD

94. EXPEDITURE PATTERN METHOD
 Determine money spent on food and non food items by questionnaire
and compare the two
 Reference period is fixed (eg. Previous month/ week)
 Indirect method
DISADVANTAGES:
 Food wasted or food given away is not accounted for: consumption
may be overestimated
 The size of the household may be different from the number of people
who actually consumed the food over the reference period

95. DIET HISTORY METHOD

96. DIET HISTORY METHOD
 Respondent reports all food and beverages
consumed on a usual day to a trained interviewer.
 It is an accurate method for assessing the nutritional status.
 The interviewer probes the further on frequency,
amount and portion size consumed.
 Diet diaries are sometimes used to assist
respondents in recalling their intakes.
 Assess qualitative and frequency intake of food
 Used to study :
Meal pattern
Dietary habits
Peoples’ food preference and avoidance during
special physiological conditions

97. DIET HISTORY METHOD
ADVANTAGES
Respondent burden is low
Complete intakes are provided
LIMITATIONS
Time consuming
Need for trained interviewers
Lack of standardization

98. RECORDING METHOD

99. RECORDING METHOD
Record of all items of food eaten by a family / individual is maintained by
weighing of quantities eaten.
ADVANTAGES:
 If followed with proper instructions a large sample can be covered in
short time.
 Mailed questionnaire can also be used for it.
DISADVANTAGE:
 Validity not established

100. FOOD DAIRY
Food intake (types & amounts) should be recorded by
the subject at the time of consumption.
The length of the collection period range between 1- 7
days.
Reliable but difficult to maintain.

101. OBSERVED FOOD CONSUMPTION
 The most unused method in clinical practice, but it is recommended
for research purposes.
 The meal eaten by the individual is weighed and contents are
exactly calculated.
 The method is characterized by having a high degree of accuracy
but expensive & needs time & efforts.

102. INTERPRETATION OF DIETARY D ATA
1. Qualitative Method
 using the food pyramid & the basic food groups method.
 Different nutrients are classified into 5 groups (fat & oils, bread &
cereals, milk products, meat-fish- poultry, vegetables & fruits)
 determine the number of serving from each group &
compare it with minimum requirement.

103. INTERPRETATION OF DIETARY DATA
2. Quantitative Method
 The amount of energy & specific nutrients in each food
consumed can be calculated using food composition tables &
then compare it with the recommended daily intake.
 Evaluation by this method is expensive & time consuming, unless
computing facilities are available.

104. Type of Dietary Survey

105. PROBLEMS IN DIETARY SURVEYS
PROBLEM IN DATA COLLECTION
 Area of survey (interior/ unapproachable)
 Distance
 Lack of rapport with respondent / community
 Duration and inconvenient timings of survey
PROBLEM IN ANALYSIS
 Lack of trained personnel
 Delay in analysis due to improper tabulation

106. NUTRITION SURVEYS IN INDIA
 National Nutrition Monitoring Bureau
 India Nutrition Profile (INP) Survey
 National Family Health Survey (NFHS)
 Micronutrients Surveys
 District Level Household Survey

107. FUNCTIONAL ASSESSMENT
 Functional indicators of nutritional status are diagnostic tests to determine the
sufficiency of host nutritional status
 Functional indices of nutritional status include cognitive ability, disease
response, reproductive competence, physical activity, work performance
 Increased severity of malnutrition is associated with an increased heart rate
 Lactation performance
 Growth velocity
 Social performance
 Prenatally undernourished infants show several behavioural impairments

108. RADIOLOGICAL EXAMINATION
 These tests are used in specific studies where additional
information regarding change in the bone or muscular
performance is requiredWhen clinical examination is suggestive
 rickets, there is healed concave line of increased density at distal
ends of long bones usually the radius and ulna.
 In infantile scurvy there is ground glass appearance of long bones
with loss of density.
 In beriberi there is increased cardiac size as visible through X-rays.
 Drawback, sophisticated and expensive equipments along with
technical knowledge are required in the interpreting data.

109. What method is the most practical and accurate
way to measure regional adiposity?
 A. Waist and hip circumference
 B. Skin-fold thickness testing
 C. Body mass index (BMI)
 D. Impedance measurement

110. What is the best way to measure
nutritional status in a pregnant female?
 A. Waist circumference
 B. Body mass index (BMI)
 C. Mid-upper arm circumference
 D. Triceps skinfold measurement

111. 12/18/2016