Nutritional assessment

1. NUTRITIONAL STATUS ASSESSMENT
SUBMITTED BY:
SREENIVASULU.E,
NURSING TUTOR,
SIMS INSTITUTE OF
NURSING.
SUBMITTED TO:
MS.PADMASREE
M.SC.,M.PHIL,
NURSING PRINCIPAL,
SIMS GROUP OF
INSTITUTIONS.

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

3. The purposes of Nutritional
Assessment
To Identify the malnourished and high risk
groups to become malnourished
To improve the nutrition at house hold level
especially for vulnerable groups
To Identify dietary trends .
To develop national health programs that meet
the community needs based on evidence
To know the preferred and not preferred food
items

4. Methods of Nutritional Assessment
These are summarized as ABCDEF
• Anthropometric methods
• Biochemical, laboratory methods
• Clinical methods
• Dietary intake assessment
• Ecological factors
• Functional assessment

5. Anthropometric Methods
It is an essential component of clinical examination
of infants, children & pregnant women
Anthropometry is the measurement of body height,
weight, Skin fold thickness & MAC,MAMC etc.
It is used to evaluate both under & over nutrition.
If it is recorded over a period of time it will reflect
pattern of growth and development.
It shows deviation from the average at various ages
Eg:- Body Size, Build and Nutritional status.

6. Anthropometric Measurements
• Height
• Weight
• Skin fold thickness
• Mid-arm circumference
• Mid-arm muscle circumference

7. Height:
The subject stands erect &
bare footed on a
stadiometer with a movable
head piece. The head piece
is leveled with skull vault &
height is recorded to the
nearest 0.5 cm.

8. WEIGHT MEASUREMENT
Use a regularly calibrated electronic or
balanced-beam scale. Spring scales are
less reliable.
Weigh in light clothes, no shoes

9. Skin fold thickness

10. Mid-arm circumference
Measure of
fat,muscle and
skeleton

11. Mid-arm muscle circumference
An estimate of
lean body mass
or skeletal
muscle reserves.
MAMC =MAC(cm)-
3.143TSF(mm)/10

12. Standard values for
Anthroprometricmeasurements
for adults
Measurement Male Female
TSF(mm) 12 20
MAC(cm) 32 28
MAMC(cm) 54 30

13. Biochemical Laboratory Assessment
 Serum Proteins
Haemoglobin
Albumin
Transferrin
Prealbumin
 Urinary tests
Urinary urea nitrogen
Urinary urea creatinine
 Total lymphocyte count

14. Clinical examination
• Area of examination
General apperance
Weight
Skin
• Signs of malnutrition
Apathetic ,looks tired ,
easily fatigued
Overweight /underweight
Dry, scaly; pale or
pigmented,edema lack
of sub cutaneous
tissue

15. Nails
Hair
Lips
Tongue
Gums
Brittle, pale,ridged or spoon shaped
(iron)
Dry, dull, loss of colour,brittle
Swollen,red cracks at side of mouth,
vertical fissures(vit- B)
Swollen,beefy red (vit-B),
increase/decrease in size
Spongy,swollen,bleed easily (vit C)

16. Muscles
G.I
Nervous
system
Under developed, flaccid,wasted, soft
Anorexia, indigestion, diarrhea,
constipation, protruding abdomen
Decreased reflexes, sensory
loss,burning and tingling of hands
and feet,mental confusion ,irritability

17. Signs of malnutrition

18. DIETARY ASSESSMENT
• Nutritional intake of humans is assessed
– 24 hours oral recall method.
– Food Frequency record
– Food dairy
– Dietary history

19. 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

20. DIETARY HISTORY
 It is an accurate method for assessing
the nutritional status.
 The information should be collected by
a trained interviewer.
 Details about usual intake, types,
amount, frequency & timing needs to
be obtained.
 Cross-checking to verify data is
important.

21. 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.

22. Assessment of Ecological
factors
• Socio economic factors
• Health and Educational services
• Conditioning Influence
• Cultural and religious beliefs
• Living arrangements