Nutritional Status Assessment

• Stages is in the development of nutritional problem:

  
• Anthropometry is the term used to describe the study of the physical dimensions of the human body and nutritional anthropometry is the term used to describe the measurement of these dimensions for nutritional assessment.
• Anthropometric Measurements tools

  • Weight

  • Height

  • Mid-upper arm

  • Waist (abdominal) and Hip circumference and triceps skinfold are by for the most widely used.
• Information provided by anthropometric measurements.

  
• Laboratory Assessment:

  • Blood- plasma, whole blood or blood. Mostly because blood is readily obtained.
  • Tissues: Liver for Vit A.
  • Urine- concentration of nutrients or breakdown of products reflects recent nutritional status.
• Assessment of nutritional status involves integrating information from a number of different sources.
• Anthropometric methods to assess growth and development, particularly in young children, are the most widely used indicators of nutritional status.
• Nutrition screening is a quick and simple identification of people who may be malnourished or at risk of malnutrition and need more detailed nutrition assessment.
• Nutritional assessment can be defined as the interpretation from dietary, laboratory, anthropometric, and clinical studies.

  It is used to determine the nutritional status of individual or

  population groups as influenced by the intake and utilisation of nutrients.
• Health workers assess clients' nutritional status for many

  reasons:

  • To identify people at risk of malnutrition for early

  intervention or referral before they become malnourished

  • To identify malnourished clients for treatment

  • To track child growth
• Simple nutrition screening can include checking for bilateral

  pitting edema, measuring weight and mid-upper arm

  circumference (MUAC)and asking about recent illnesses and appetite.
• When assessing nutritional status for a group of adults, health workers must give priority to people with HIV and Aids, TB or other chronic diseases.
• How often Nutritional assessment should be done:

  • People with HIV: every visit & when changing ART
  • Children 5 years of age and over: on every clinic visit
• How often Nutritional assessment should be done:

  • People with HIV: every visit & when changing ART
  • Children 5 years of age and over: on every clinic visit
• Nutritional assessment can be done using the ABCD methods:

  • Anthropometry
  • Biochemical/Laboratory methods
  • Clinical methods
  • Dietary methods
• The core elements of anthropometry are height, weight, body mass index (BMI), body circumferences (waist, hip, head and limbs (MUAC)), and skinfold thickness.
• Accurate weight measurement is important because errors

  can lead to incorrect classification of nutritional status and

  the wrong care and treatment.
• Healthy range BMI is 18.5-24.9.
• MUAC is the circumference of the left upper arm measured

  at the mid-point between the tip of the shoulder and the tip of the elbow, using a measuring or MUAC tape.
• Calibrated calipers are used to measure the thickness of a fold of skin at defined body sites that include upper arm or triceps, subscapular region, and upper abdomen.
• Laboratory Assessment of Nutritional Status. Nutritional

  information can be obtained from plasma, serum, urine, stool, hair, and nail samples.
• Clinical methods of assessing nutritional status involve

  checking signs of deficiency at specific places on the body or asking the patient whether they have any symptoms that

  might suggest nutrient deficiency from the patient.
• General clinical examination, with special attention to organs like hair, angles of the mouth, gums, nails, skin, eyes, tongue, muscles, bones, & thyroid gland.
• 24 Hour dietary recall is a common way to assess dietary

  intake for an individual or a group of people.
• A comprehensive nutritional assessment includes:

  (1) anthropometric measurements of growth and body

  composition;

  (2) biochemical measurements of serum protein, micronutrients, and metabolic parameters;

  (3) clinical assessment of altered nutritional requirements and social or psychological issues that may preclude adequate intake

  (4)dietary assessment on quantity and quality of food intake
• Compared to these anthropometric , clinical, and dietary

  methods, biochemical parameters represent better, more

  precise, and objective tools for the assessment of the

  nutritional status of children.