2 Nutritional Assessment

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 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

Methods of Nutritional Assessment

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

What the Measurement

Indicates

Weight Body mass

Length or Height Skeletal growth

Knee Height Skeletal growth

Skinfold Thickness Body fat

Mid-upper arm

Circumference

Fat and fat free mass

Mid-arm Circumference Fat free mass

Waist/Hip Ratio 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 Dietary inadequacy Dietary

2 Decreased level in reserve tissue store Biochemical

3 Decreased level in body fluids Biochemical

4 Decreased functional level in tissues Anthropometric/

Biochemical

5 Decreased Activity in nutrient-dependent

enzyme

Biochemical

6 Functional change Behavioral/

Physiological

7 Clinical symptoms Clinical

8 Anatomical sign 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 Z-

scores weight-for-height

Severe acute malnutrition (SAM) means weight of children under 5 years is

less than 70% of the median weight-for-

height or less than -3 Z-scores weight-for-

height.