Assessments of Nutritional Status Flashcards
(40 cards)
Nutritional Assessment Why?
1) Identify individuals or population groups at risk of becoming malnourished
2) Identify individuals or population
groups who are malnourished
3) To develop health care programs that meet the community needs, which are defined by the assessment
4) To measure the effectiveness of the nutritional programs & intervention once initiated
Methods of Nutritional Assessment
1) Direct
2) Indirect
Direct Methods of Nutritional Assessment
These are summarized as ABCD
• Anthropometric methods
• Biochemical, laboratory methods
• Clinical methods
• Dietary evaluation methods
Indirect Methods of Nutritional Assessment
These include three categories:
1) Ecological variables, including crop production
2) Economic factors e.g. per capita income, population density & social habits
3)Vital health statistics, particularly infant & under 5 mortality & fertility index
CLINICAL ASSESSMENT
1) It is the simplest & most practical method of ascertaining the nutritional status of a group of individuals
2) It utilizes a number of physical signs, (specific & non specific), that are known to be associated with malnutrition and deficiency of vitamins & micronutrients
3) General clinical examination, with special attention to organs like hair, angles of the mouth, gums, nails, skin, eyes, tongue, muscles, bones, &
thyroid gland.
4) Detection of relevant signs helps in establishing the nutritional diagnosis
MALNUTRITION
– the person losing weight unintentionally
– the person eating/ drinking less than usual
– constipation or diarrhea
– lost muscle
– difficulty in recovering from an illness
– showing signs of pressure ulcers, or have a dry skin
– Have difficulties in chewing or swallowing
– suffer from a sore mouth, or tongue, bleeding, or swollen gums
CLINICAL ASSESSMENT (AD & DIS)
• ADVANTAGES
–Fast & Easy to perform
– Inexpensive
– Non-invasive
• LIMITATIONS
– Did not detect early cases
Clinical signs of nutritional deficiency (HAIR)
1) Spare & thin ===> Protein, zinc, biotin deficiency
2) Easy to pull out ==> Protein deficiency
3) Corkscrew Coiled hair => Vit C & Vit A deficiency
Clinical signs of nutritional deficiency (MOUTH)
1) Glossitis ==> Riboflavin, niacin, folic acid, B12.
2) Bleeding & spongy gums => Vit. C,A, K, folic acid
& niacin
3) Angular stomatitis, cheilosis & fissured tongue
==> B 2, 6, & niacin
4) Leukoplakia => Vit.A,B12, B-complex, folic acid & niacin
5) Sore mouth & tongue ==> Vit B12,6,C,niacin ,folic acid & iron
Clinical signs of nutritional deficiency (EYES)
1) Night blindness, ==> Vitamin A deficiency
exophthalmia
2) Photophobiablurring, conjunctival inflammation
==> Vit B2 & vit A deficiencies
Clinical signs of nutritional deficiency (NAILS)
1) Spooning ==> Iron deficiency
2) Tranverse Lines ==> Protein Deficiency
Clinical signs of nutritional deficiency (SKIN)
1) Pallor ==> Folic acid, iron, B12
2) Follicular hyperkeratosis =>Vitamin B & VitaminC
3) Flaking dermatitis => PEM, Vit B2, Vitamin A, Zinc & Niacin
4) Pigmentation, Desquamation => Niacin & PEM
5) Bruising, purpura==> Vit K ,Vit C & folic acid
Thyroid gland
In mountainous areas and far from sea places.
Goiter is a reliable sign of iodine deficiency.
Joins & bones
Help detect signs of vitamin D deficiency (Rickets) & vitamin C deficiency (Scurvy)
Anthropometric Methods
1) Anthropometry is the measurement of body
height, weight & proportions.
2) It is an essential component of clinical
examination of infants, children & pregnant
women.
3) It is used to evaluate both under & over nutrition.
4) The measured values reflects the current
nutritional status & don’t differentiate between acute & chronic changes .
Other anthropometric Measurements
• Mid-arm circumference
• Skin fold thickness
• Head circumference
• Head/chest ratio
• Hip/waist ratio
Anthropometry for children
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
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.
WEIGHT MEASUREMENT (Weight)
1) Use a regularly calibrated electronic or balanced-beam scale. Spring scales are less reliable.
2) Weigh in light clothes, no shoes
3) Read to the nearest 100 gm (0.1kg)
BMI (WHO - Classification)
BMI < 18.5 = Under Weight
BMI 18.5-24.5= Healthy weight range
BMI 25-30 = Overweight (grade 1obesity)
BMI >30-40 = Obese (grade 2 obesity)
BMI >40 =Very obese (morbid or grade 3 obesity)
Waist/Hip Ratio
1) Waist circumference is measured at the level of the umbilicus to the nearest 0.5 cm.
2) The subject stands erect with relaxed abdominal muscles, arms at the side, and feet together.
3) The measurement should be taken at the end of a normal expiration.
Waist circumference
1) Waist circumference predicts mortality better
than any other anthropometric measurement.
2) It has been proposed that waist measurement
alone can be used to assess obesity, and two
levels of risk have been identified
MALES FEMALE LEVEL 1 > 94cm > 80cm LEVEL2 > 102cm > 88cm
Hip Circumference
1) Is measured at the point of greatest
circumference around hips & buttocks to the
nearest 0.5 cm.
2) The subject should be standing, and the measurer should squat beside him.
3) Both measurements should be taken with a flexible, non-stretchable tape in close contact with the skins, but without indenting the soft tissue.
Interpretation of WHR
1) High risk WHR= >0.80 for females & >0.95 for males i.e. waist measurement
2) >80% of hip measurement for women and >95% for men indicates central (upper body) obesity and is considered high risk for diabetes & CVS disorders.
3) A WHR below these cut-off levels is considered low risk.
