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NUTRITIONAL

ASSESSMENT BY DIET
SURVEY
INTRODUCTION

The nutritional status of an individual is often the result of


many interrelated factors. It is influenced by the adequacy
of food intake both in terms of quantity and quality and
also by the physical health of the individual. The
nutritional status of a community is the sum of the
nutritional status of the individuals who form that
community.
Objectives of Nutritional Assessment

The objectives are :

To obtain precise information on the prevalence and


distribution of nutritional problems of a given family.
Identification of individuals or population groups at risk or in
greatest needs of assistance.
To develop a health care programme that meets the needs
defined by that assessment, including evaluation of the
effectiveness of such programmes.
METHODS OF NUTRITIONAL ASSESSMENT

DIRECT INDIRECT
1.Anthropometry 1.Vital statistics

2.Biochemical investigation 2.Ecological factors

3.Clinical examination 3.Functional assessment

4.Dietary survey
BALANCED DIET

A balanced diet is defined as one which


contains a variety of foods in such
quantities and proportions that the need
for energy, amino acids, vitamins,
minerals, fats, carbohydrates and other
nutrients is adequately met for
maintaining health, vitality and general
well-being and also makes a small
provision for extra nutrients to withstand
short duration of leaness.
The methods of diet survey are many of
which the following are most commonly
used –

1.Weightment of Raw Foods


2. Weightment of Cooked Foods
3. 24 hour Recall method
The 24 hour recall/oral questionnaire method is one in which inquiries
are made retrospectively about the nature and quantity of foods eaten
during the last 24 hours. However, this method has certain fallacies –

1.There can be a fast observed in the previous 24 hours hence,


RESTRICTED FOOD CONSUMPTION
2.There may be a feast celebrated in the previous 24 hours HENCE,
INCREASED AND ATYPICAL FOOD CONSUMPTION
3. The method depends on the subject’s ability to recall from memory all
that he/she has eaten in the previous 24 hours hence, it may not be
inaccurate in some cases
4. There may be day to day variation in the food consumption
5. Some members of the family may be following restricted diets due to
certain illnesses.
METHOD: 24 hour recall method of dietary survey.

OBJECTIVES

 To assess the nutritional status of the members of the allotted


family.

 To assess the dietary intake patterns and calculate if there is


any deficiency/ excess in calorie/ protein intake.

 To suggest some recommendations for improvement.


MATERIALS AND METHODOLOGY
Study type: Observational, Descriptive, Cross-sectional

Study period: 3rd February, 2016- 20th February, 2016.

Study area : Simultala, Sonarpur

Study population: 3 members

Study tools: Measuring tape, Camera, Weighing machine, stethoscope,


Sphygmomanometer, Practical Guide Book.

Study Technique : Data was collected by interviewing the


family members & taking measurements
wherever necessary
SR. NAME AGE SEX Relation MARITAL EDUCATIO
NO. with HOF STATUS N
1. Mr. 40 Male H.O.F Married Till class 5
Shamshuddin years
Haldar
2. Mrs. Ayesha 37 Female Wife of H.O. Married Till class 6
Haldar years F

3. Miss Sarika 15 Female Daughter of Unmarrie Class 10


Haldar years H.O.F d (present)

Type of family- NUCLEAR family


Phase of nuclear family- EXTENSION phase
Sr. NAME OCCUPATIO NATURE TYPE OF INCOME ADDICTION
No. N OF WORK WORK
1. Mr. Contracter Sedentar Unskille INR5000 Chews
Shamshuddin (dalal) y d tobacco
Haldar

2. Mrs. Ayesha House-wife Sedentar Unskille None None


Haldar y d

3. Miss Sarika Student Sedentar Unskille None None


Haldar y d
SR. NO NAME PRESENT PAST ILLNESS
ILLNESS
1. Mr. Shamshuddin Haldar Nothing RTA- head and
significant. leg injured.n
2. Mrs. Ayesha Chest pain, joint Nothing
Haldar pain. significant.
3. Miss Sarika Haldar Nothing Nothing
significant. significant.

PRIORITY MEMBERS OF THE ALLOTTED FAMILY

Ms. Sarika Haldar of adolescent age group

Mrs. Ayesha Haldar of reproductive age group

Mr. Shamshuddin Haldar (obese)


SOCIO-ECONOMIC STATUS
• Socioeconomic status has been defined as the position that
an individual or family occupies with reference to the
prevailing average standards of cultural and material
positions, income and participation in group activities of the
community.
• Kuppuswamy in India prepared a scale based on education,
occupation of the head of the family and total income which
are the three major variables contributing to the
socioeconomic status in urban areas. This scale is called the
Revised Kuppuswamy Scale (For 2007).
A. EDUCATION SCORE B. OCCUPATION SCORE

Profession or Honours 7 Profession 10

Graduate or Post 6 Semi Profession 6


Graduate

Intermediate or Post 5 Clerical Shop Owner, 5


High School Diploma Farmer

High School Certificate 4 Skilled Worker 4

Middle School Certificate 3 Semi Skilled Worker 3

Primary School 2 Unskilled Worker 2


Certificate

Illiterate 1 Unemployed 1
Family Income Per Month(in Rs.) Modified For Score
2007

= 19,575 12
9788-19574 10
7323-9787 6
4894-7322 4
2936-4893 3
980-2935 2
<979 1
Total Score Socio economic class

26-29 Upper( I )

16-25 Upper – middle ( II )

11-15 middle Lower middle( III )

5-10 lower Upper lower ( IV )

<5 Lower ( V )
BREAKFAST
TEA- 1cup
BISCUITS- 2 pieces
PARATHA- 1 piece
POTATO CURRY- 1 bowl

LUNCH + DINNER
RICE
CHICKEN
BRINJAL
PUMPKIN
DAAL
GREEN LEAFY VEGETABLES

EVENING SNACKS

SAMOSA- 3 pieces
PUFFED RICE
TEA- 1 cup
APPLE- 1
Sl. Food Groups Calorie (Kcal) Protein (gm)
No
1. Cereals :
Rice –750g 2595 48
Puffed Rice/Muri – 100g 346 6
Paratha- 1 piece 170 3

2. Pulses :
Dal- 100g 348 24.5

3. Animal Product
Chicken- 500g 545 125

4. Milk and Milk Products –


Mother Dairy Packet Milk –
500ml 335 16
Sl. No Food Groups Calorie (Kcal) Protein (gm)

5. Fats and Oils :


Cooking Oil- 166ml 1500 -
6. Green leafy vegetables :
Amaranth- 500g 225 20
7. Other vegetables :
Brinjal- 300gm 72 4.2
Pumpkin- 500g 125 7
8. Roots and Tubers :
Potato – 600g 582 9.6
Onion – 150g 75 1.7

9. Fruits :
Apple- 200g 118 0.4
10. Sugar and Jaggery :
Sugar – 30g 120 -

111. Other foods –


Biscuits- 2 pieces 420 -
Samosa- 3 pieces 600 -
The total calorie intake is calculated by
adding up the calories present in the food,
as shown in the previous slides –

= 8176 kcal

The total protein intake is calculated


similarly –

= 265.4g
A consumption unit is defined as the total amount of
calories required by a sedentary man which is –

1 CONSUMPTION UNIT = 2320 Kcal


GROUP Consumption Unit (C.U.)
Adult male (sedentary worker) 1.0
Adult male (moderate worker) 1.2
Adult male (heavy worker) 1.6
Adult female (sedentary worker) 0.8
Adult female (moderate worker) 0.9
Adult female (heavy worker) 1.2
12 to 21 years 1.0
9 to 12 years 0.8
7 to 9 years 0.7
5 to 7 years 0.6
3 to 5 years 0.5
1 to 3 years 0.4
Name of Member Nature of worker C. U. Protein reqd.
(daily)
Mr. Shamshuddin Sedentary 1.0 90g
Haldar

Mrs. Ayesha Haldar Sedentary 0.8 59g

Ms. Sarika Haldar Sedentary 1.0 40g

TOTAL CU – 2.8
Total consumption unit of family –2.8
Thus, the required calorie intake of the Haldar family is 6496 Kcal

Calculated calorie intake is 8176 kcal

Hence, calorie surplus of 1680 kcal or 20.55%


Total protein requirement of family – 189g

Calculated protein intake – 265.4g

Hence, protein surplus of 76.4g or 28.79%


CLASSIFICATION BMI (WHO) BMI (INDIAN)
UNDERWEIGHT < 18.50 < 18.5

NORMAL RANGE 18.50 – 24.99 18.5-22.99

OVERWEIGHT 25.00-29.99 23-24.99


OBESE >= 30 >= 25

SI. NAME WEIGHT HEIGHT B.M.I CONCLUSION


NO (Kgs) (mtrs)

1. Shamshuddi
n Haldar 90 1.78 28.4 OBESE

2. Ayesha
Haldar 59 1.52 25.5 OBESE
We interviewed the allotted family on 9th February, 2016. The family
consists of Mr. Shamshuddin Haldar (HOF), his wife and his daughter.
They belong to Upper- Lower socioeconomic class according to the
modified Kuppuswamy Scale. According to the conducted diet survey
by the 24 hour recall method, the daily calorie intake by the family is
8176 kcal and the required daily calorie intake should be 6496 kcal.
Thus, there is a surplus of 20.55%. The daily protein intake by the
family is 265.4g whie the required daily intake is 189g. Therefore, there
is a surplus of 28.79%. The BMI values of the adults of the family
shows a state of obesity for Mr. Shamshuddin Haldar (HOF) and Mrs.
Ayesha Haldar (wife of HOF). Ms. Sarika Haldar is underweight with
reference to the standard values for Indians.
Individual level:

•The HOF and his wife were advised to take up physical activities like brisk
walks to reduce their weight as they were obese, and to also limit their daily
calorie and protein intake.
•Ms. Sarika Haldar was advised to not skip breakfast and to eat more fruits
and increase her consumption of chicken, fish and milk.
•Ms. Sarika Haldar was also advised to visit the Anganwadi Centre to avail
their services on supplementary nutrition and, nutrition and health
education.
•Mrs. Ayesha Haldar was advised to reduce her daily salt intake as she was
pre-hypertensive and to visit the Anganwadi Centre to avail their service on
Nutrition and Health education.
Family level:
•The members of the allotted family were advised to reduce their daily
intake of fried foods and thus, decrease their daily oil consumption which
amounted to 166ml.
•The family members are advised to carry out proper distribution of food
to ensure a healthy living for all its members. It is important to note that
despite having both calorie and protein excess in their diet, Ms. Sarika
Haldar is underweight.
•All the family members should visit IIMC (Institute for Indian Mother and
Child) which is the urban training centre of KPC Medical College &
Hospital for regular health check up.
Community level:
• The community should encourage physical exercise
for persons belonging to the obese category.

• The community should also educate people about the


high risks of obesity.
I would like to thank all the teachers of the
Department of Community Medicine for giving us
this opportunity. We are grateful to our allotted
family for their cordial behavior and cooperation
without which this presentation would be
incomplete.
 Park.K- Textbook of Preventive and
Social Medicine,(23rd Edition)
 Practical Guide Book