Slides current until 2008 Nutrition assessment. Curriculum Module III-5 Slide 2 of 25 ACTIVITY Slides current until 2008 Identify the factors that influence.

Slides current until 2008

Nutrition assessment

Nutrition assessmentCurriculum Module III-5

Slide 2 of 25ACTIVITY


Identify the factors that influence

dietary intake.


Slide 3 of 25


Assessment of health status /1

• Socio-economic status and culture

• Dental health

• Screening for co-morbidity, e.g. coeliac disease


Slide 4 of 25


Assessment of health status /2

• Laboratory tests to determine clinical status

– fasting glucose, HbA1c level

– lipid profile (cholesterol — HDL, LDL)

– haemoglobin, ferritin, creatinine, U and E’s, thyroid function

• Screening for complications e.g. cardiovascular, renal disease

• Current medication and nutrient supplements


Slide 5 of 25


• Body weight

• Height

• Agreed acceptable weight

– using standard height/weight tables

Anthropometric measurements


Slide 6 of 25


Weight and height measurements to calculate BMI:

BMI = weight in kg/(height in m)2

Standard BMI normograms: 21-25 desirable

25-30 overweight

>30 obese

Geographical variations exist

Body Mass Index (BMI)




Body Mass Index (BMI)

Calculate the individual BMI of your

fellow participants.


Slide 8 of 25


Waist-to-hip ratio (WHR)

• Central adiposity – important cardiovascular risk marker

• High WHR – increased risk

• WHR used to define body shape

• A pear-shaped body is preferable to an apple-shaped body


Slide 9 of 25


Measuring WHR

The hip circumference is the largest circumference at the posterior extensive of the buttocks

The waist circumference is the smallest circumference below the rib cage and above the umbilicus


Slide 10 of 25


Central obesity

plus any two of the following four factors:

- raised triglycerides- reduced HDL cholesterol- raised blood pressure- raised fasting blood glucose

IDF definition of the metabolic syndrome


Slide 11 of 25


Dietary assessment

• Dietary history

– usual food intake recorded through interview

• Dietary recall

– food and drink consumed in previous 24 hours (24-hour recall)


Slide 12 of 25


Dietary history and recall tips

Ask for or check:

• Food pattern on a normal day

• Size of portions at home

• Daily/weekly/monthly purchases

• Eating out and take-away – frequency

• Food favourites – self and family

• Food products, e.g. skimmed or whole milk

• Hunger patterns




Identify some disadvantages of

the dietary recall method


Slide 14 of 25


• Food frequency questionnaire

• Prospective food records

• Weighed food records

Detailed dietary assessment methods


Slide 15 of 25


Groups with special dietary needs

• Pregnant women

• People with a gastro-intestinal condition, such as coeliac disease

• Older people




Interpreting assessment data

Analyse the information collected from the

assessment process

What further considerations are necessary

before the management plan is agreed on?


Slide 17 of 25


Summary

• Detailed assessment

• Multiple factors for assessment

• Variety of assessment methods

• Special groups


Slide 18 of 25


Giving nutrition education to people

without first analysing their nutritional

and health status is like sailing a ship in a

fog without a compass, charts or

information about the weather and

currents.


Slide 19 of 25


Review question

1. Which of the following is NOT a goal of nutritional assessment?

a. To identify malnutrition (under and overweight)

b. To identify those at risk of nutritional deficiencies

c. To identify eating habits that may be associated with poor diabetes control and increased risk of cardiovascular disease

d. To allow people to choose their own treatment plan


Slide 20 of 25


Review question

2. In European populations, which BMI is classified as obese?

a. 24

b. 26

c. 28

d. 31


Slide 21 of 25


Review question

3. When describing central adiposity, which fruit shape is associated with an increased risk of cardiovascular disease?

a. Apple

b. Pear

c. Orange

d. Melon


Slide 22 of 25


Review question

4. Which of the following is NOT included in the IDF definition of the metabolic syndrome?

a. Raised fasting blood glucose

b. Raised blood pressure

c. Reduced LDL cholesterol

d. Raised triglycerides


Slide 23 of 25


Review question

5. Which of the following is NOT used to assess diet in normal clinical practice

a. Food diaries

b. Weighed food records

c. Diet histories

d. Diet recall


Slide 24 of 25


Answers

1. d

2. d

3. a

4. c

5. b


Slide 25 of 25


References

1. American Diabetes Association. Diabetic Nephropathy. Diabetes Care 2004; 27(suppl 1).

2. American Diabetes Association. Dyslipidemia Management in Adults with Diabetes. Diabetes Care 2004; 27(suppl 1): S68-71.

3. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2004; 27(suppl 1): S19.

4. Anil Kapur, et al. Novovare Interactive Nutrition Assistant - A computer aided Interactive Nutrition Management Program, Novo Nordisk. Diabetes Update Proceedings 1997.

5. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2003; 27(suppl 2): S19.

6. International Diabetes Federation. www.idf.org

7. Maryniuk MD. The new shape of medical nutrition therapy. Diabetes Spectrum 2000; 13(3): 122-24.

Slides current until 2008 Nutrition assessment. Curriculum Module III-5 Slide 2 of 25 ACTIVITY Slides current until 2008 Identify the factors that influence.

Documents

activityslides current

umbilicusslides current

hour recall slides current

coeliac diseaseslides

body weight height

dietary intake

acceptable weight

individual bmi