Let Me Hear Your Body Talk The nutrition-focused physical · PDF fileLet Me Hear Your Body Talk The Nutrition-Focused Physical Coco Newton, MPH, RD, CCN Webinar, Dietitians in

Let Me Hear

Your Body

Talk The Nutrition-Focused Physical

Coco Newton, MPH, RD, CCN www.coconewton.com

Webinar, Dietitians in Integrative & Functional Medicine September 18, 2014

VALUE of Nutrition-Focused Physical

Enhances successful outcomes

Enhances therapeutic relationship

Collective Wisdom

Adele Huls, PhD, RD nutritionfocusedexam.com

Cindy Hamilton, MS, RD, CNSD (webinar, eatright.org)

The Use of Nutrition Focused Physical Exam & Functional

Parameters to Determine Malnutrition Dietitians in

Nutrition Support DPG (10/20/11)

Kathie Swift, MS, RD (instructor) Nutrition-Focused

Physical Exam in Nutrition in Practice Food As Medicine,

Center for Mind-Body Medicine cmbm.org/fam (2012)

Kathleen Mahan, Sylvia Escott-Stump, Janice L.

Raymond. Krauses Food & The Nutrition Care Process,

13th Ed. pp.1075-1099, ( 2012)

Collective Wisdom

Mary Ann Kight. et al. Conducting Physical

Examination Rounds for Manifestations of Nutrient

Deficiency or Excess: An Essential Component of

JCAHO Assessment Performance. Nutrition In Clinical

Practice; 14(2):93 (April 1, 1999)

Mary D. Litchford, PhD, RD, LDN (author)

casesoftware.com

Nutrition Focused Physical Assessment: Making

Clinical Connections (2012)

Collective Wisdom

Michael Stone, MD, MS (instructor)

Nutrition-Related Physical Exam for Nutrition

Professionals Applying Functional Nutrition for

Chronic Disease Prevention & Management Course

at Institute for Functional Medicine (2010-2012)

Ruth Leyse-Wallace, PhD, RD Nutrition Focused

Physical Examinations ruthlysewallace.com

Adele Huls, PhD, RD, LMNT

Diana Noland, MPH, RD, CCN

Nutrition-focused physical exam: checklist http://www.dietetics.kumc.edu/events/nutrition-focused-physical-exam-checklist.pdf

Key terms for performance of nutrition-focused physical exam http://www.dietetics.kumc.edu/events/Key-Terms-Performance%20-Nutrition-focused-Physical-Exam.pdf

Resources for the nutrition-focused physical exam http://www.dietetics.kumc.edu/events/Nutrition-focused-physical-exam-Resources.pdf

Most commonly observed clinical signs and symptoms http://www.dietetics.kumc.edu/events/Clinical-Signs-Symptoms-Nutritional-Deficiencies.pdf

Nutrition-focused physical examination: observations http://www.dietetics.kumc.edu/events/Nutrition-focused-Physical-Examination-Observations.pdf

KUMC Clinical Nutrition Seminar (11/4/11) http://www.dietetics.kumc.edu/events/clinical-nutrition-seminar.html

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Nutrition-Focused Physical Exam

Deborah Ford, MS, RD; Sudha Raj, PhD, RD, CDN; Rita Kashi Batheja, MS, RD, CDN; Ruth DeBusk, PhD, RD, LDN; Dave Grotto, RD, LDN; Diana Noland, MPH, RD; Elizabeth Redmond, PhD, MMSc, RD, LD; Kathie Madonna Swift, MS, RD, LDN. American Dietetic Association: Standards of Practice and Standards of Professional Performance for registered dietitians (competent, proficient, and expert) in Integrative and Functional Medicine. J Am Diet Assoc. 2011;111:902-913

Tools

1. 2. 3.

5. 6.

8. 9.

1. Bioelectrical Impedance Analysis

2. Tape measure 3. ETOH glass or

Temporal Artery thermometer

4. Blood pressure 5. Pen light 6. Pulse oximeter 7. Reflex hammer 8. Scale 9. Tongue depressor

4.

7. 8.

1st impression?

Looking for Nutritional Imbalances

Body Composition

Skin

Hair

Nails

Eyes

Mouth

BODY

COMPOSITION

Waist:Height better CVD predictor than BMI

300,000 people

Goal = waist circumference height

19th conference on Obesity in Lyon, France (May 12, 2012)

http://www.health-calc.com/body-composition/waist-to-height-ratio

Osteoporosis/Fatty Bone

OBESITY- 30% trabecular bone volume, porosity, stiffness

ANOREXIA- fat in bone marrow

Ecklund K et al. Bone marrow changes in adolescent girls with anorexia nervosa

J Bone Min Res Feb 2010

Cohen A, et al. Abdominal fat is associated with lower bone formation and inferior bone quality in healthy

premenopausal women: A transiliac bone biopsy study. J Clin Endocrinol Metab 2013

SKIN

Skin

Color

Temperature

Moisture

Texture

Turgor

Rashes