week 3 (async)- nutrition assessment

Question 1

why conduct nutrition assessments?

Answer 1

to determine who is malnourished (indiv level) and to evaluate the impact of nutritional interventions

Question 2

nutrition assessments

Answer 2

a measurement of the extent to which the individual’s physiological need for nutrients is being met

Question 3

optimal nutritional status

Answer 3

when energy/nutrient intake matches requirements

Question 4

what impacts nutrient intake?

Answer 4

food intake and absorption

Question 5

what impacts nutrient requirements?

Answer 5

growth, disease/infection, psychologic stress, maintenance

Question 6

types of nutritional assessements

Answer 6

antropometric mesurements, biochemical indicators, clinical indications and dietary patterns

Question 7

anthropometry

Answer 7

mesurement of physical dimensions and gross composition of the body, results are compared standard values
ie. height, weight, mid-upper arm circumference (MUAC)

Question 8

does ethnicity influence growth pattern?

Answer 8

ethnicity does not impact growth early in life, it is access to recources (food, HC services) that impacts growth rate

Question 9

wasting

Answer 9

• low weight for height, reflects acute malnutrition
• generally a result of weight loss due to recent period of starvation or severe disease

Question 10

severe acute malnutrition

Answer 10

weight-for-height is -3SD or more below WHO standard

Question 11

moderate acute malnutrition

Answer 11

weight-for-height is between -2 to -3SD below WHO standard

Question 12

mid upper arm circumference (MUAC)

Answer 12

• measures muscle content, correlates with total muscle mass (reflects protein status)
• major determinants of MUAC are arm muscle and subcutaneous fa
• <12.5cm indicates moderate acute malnutrition, <11.5cm indicates severe acute malnutrition

Question 13

benefits and drawbacks of MUAC

Answer 13

PROS:
- simple, quick and accessible way of measuring nutrition status
- more sensitive measure of malnutrition than low body weight
- reveals malnutrition earlier, strong predictor of risk for death
CONS:
- can only be used for children aged 6-59 months of age
- doesn’t reveal hidden hunger

Question 14

stunting

Answer 14

• low height for weight, reflects chronic malnutrition
• child considered stunted if height-for-age is -2SD below WHO standard
• consequences include severe cognitive impairment, increased risk of disease and overall decrease in GDP

Question 15

recumbent length

Answer 15

measured if child cannot stand erect w/o assistance

Question 16

underweight

Answer 16

• low weight-for-age
• influenced by both height-for-age and weight-for-height so interpretation can be difficult
• reflects chronic or acute malnutrition

Question 17

BMI

Answer 17

used to classify weight status in adults, normal BMI is 18.5-24.9

Question 18

biochemical measurements

Answer 18

measure a nutrient or its metabolite in blood, urine, feces

Question 19

clinical indicators

Answer 19

• use medical history and physical examination to detect and interpret the signs and symptoms of malnutrition
• signs are observed, symptoms are reported

Question 20

hair

clinical indicator

Answer 20

• depigmentation of hair suggests protein deficiency
• flag sign is a transverse depigmentation of hair (reflects period of undernutrition and then improvement)

Question 21

eyes

clinical indicator

Answer 21

• xeropthalmia, night blindness, photophobia, bitot’s spots corneal ulceration or scarring are all indicative of vitamin A deficiency
• bitot’s spots are white foamy plaques lateral to cornea

Question 22

skin

clinical indicator

Answer 22

pallor of skin and conjunctiva indicate iron deficiency anemia

Question 23

nails

clinical indicator

Answer 23

• traverse ridging indicates protein deficiency
• spoon-shaped nails indicates iron deficiency anemia

Question 24

edema

clinical indicator

Answer 24

• swelling due to excess fluid accumulation
• bilateral pitting edema is indicative of SAM

Question 25

limitations of clinical indicators

Answer 25

- signs and symptoms can be hard to interpret - physical signs are often nonspecific - examiner inconsistencies and inter-individual variability

Question 26

dietary assessment methods

Answer 26

measurements of foods and beverages consumed by a person in one day, several days or a longer time period ie. 24h recalls, FFQ

Question 27

24h recall

Answer 27

- participant asked for quick list of fodd/bev consumed in past 24h - starting with first item on list, interviewer probes for details - review details and amounts to correct an innacuracies

Question 28

pros and cons of 24h recall

Answer 28

PROS: - quick, inexpensive, easy - can be used in a variety of settings - does not alter diet CONS: - under/overreporting foods - relies on memory - labour-intensive data entry - one recall does not represent typical intake

Question 29

food records

Answer 29

- person records type and amount of food/beverage consumed for a period of time - lasts 1-7 days

Question 30

pros and cons of food record

Answer 30

PROS: - doesn't rely on memory - can provide great detail - can give insight into eating habits - more representative of typical intake CONS: - takes time and effort to complete (labour-intensive) - requires literacy - recording alters diet, may not represent usual intake

Question 31

food frequency questionnaires

Answer 31

can determine how often a person consumers a limited number of foods (<150)

Question 32

pros and cons of FFQ

Answer 32

PROS: - can be self-administered - machine-readable, inexpensive - may be more representative of intake CONS: - may not include foods typically consumed by the individual - may not iclude information about portion size - requires literacy - cannot ask clarifying questions

Question 33

24h recall/dietary diversity instrument

Answer 33

local foods grouped according to key nutrients

Question 34

how to determine which assessment method is best?

Answer 34

depends on goal, setting, respondants and resources available