NUTRITIONAL ASSESSMENT

Nutritional Assessment
The

interpretation of information obtained from dietary, biochemical, anthropometric, clinical studies and/or other studies to determine the nutritional status of individuals/groups and identify those at nutritional risk

Nutritional Status
condition

of health of an individual as influenced by intake and utilization of nutrients

Methods of Nutritional Assessment

Methods that provide direct information

Anthropometric

measurement Biochemical examination Biophysical technique Clinical examination

Methods of Nutritional Assessment

Methods that provide indirect information

Dietary Assessment Food consumption studies Studies on physical activities Studies on food supply Studies on demographic, socio-economic

conditions Studies on cultural and anthropological influences

Nutritional Anthropometry
concerned

with the measurement of the variations of the dimensions, proportion and gross composition of the human body at different age levels and degrees of nutrition

Examples
Common Body Measurements Weight Length or Height
Knee Height Skinfold Thickness

What the Measurement Indicates Body mass Skeletal growth

Skeletal growth Body fat

Mid-upper arm Circumference Mid-arm Circumference

Waist/Hip Ratio

Fat and fat free mass

Fat free mass Android obesity

Dietary Assessment
Determines

inadequacy of dietary and/or nutrient intakes, either because of primary or secondary deficiency

Steps in Dietary Assessment

1. Obtaining dietary information
24-hour Food Recall Food Frequency Questionnaire Food Record Dietary History 2. Dietary data analysis

Qualitative Quantitative

3. Dietary Evaluation

Scheme for the development of a nutritional deficiency

Stage Depletion Stage Method(s) Used

1
2 3 4 5 6 7 8

Dietary inadequacy
Decreased level in reserve tissue store Decreased level in body fluids Decreased functional level in tissues

Dietary
Biochemical Biochemical Anthropometric/ Biochemical

Decreased Activity in nutrient-dependent Biochemical enzyme Functional change Clinical symptoms Anatomical sign Behavioral/ Physiological Clinical Clinical

Protein Energy Malnutrition (PEM)

Kwashiorkor
Caused by inadequate protein in the presence of adequate food energy Usually experienced among 0-2 years old children Occurs after breastfeeding stops and child is weaned into a starchy diet

KWASHIORKOR

Moon face Apathetic Scrotal Edema

Hair dyspigmentation Hepatic enlargement

Flaky paint dermatosis

Marasmus
a disease of starvation, deficiency of

both protein and food energy Usually experienced among 1-3 years old children Due to inadequate breastfeeding or improper (diluted) milk formula

MARASMUS

Old man's face, "monkey face"

Severe muscle wasting Loss of subcutaneous fat

marasmic-kwashiorkor

Classifications used during Disaster and Emergency Situation

Moderate

acute malnutrition (MAM)

means weight of children under 5 years is between 70% and 80% of the median weight-for-height or between -3 and -2 Zscores weight-for-height

 Severe

acute malnutrition (SAM)

means weight of children under 5 years is less than 70% of the median weight-forheight or less than -3 Z-scores weight-forheight.