hnf 123

• Health


  A person's state of health is a continuum that can change from (1) being totally healthy and resistant to disease, to (2) having an acute illness, to (3) living with a chronic disease or condition that significantly alter one's capacity to function well, and finally to (4) having a terminal illness
• Nutrition


  Important to promote health and prevent and treat disease states

  
• Nutritional status


  • The health status of individuals or population groups as influenced by their intake and utilization of nutrients
  • Can change throughout the life cycle as it reflects the situation at a certain time point

  
• Assessment


  A process of gathering, analyzing, and interpreting information
• Nutritional (status) assessment


  • The interpretation of information from dietary, biochemical, anthropometric and clinical studies
  • Essential in the (1) identification of individuals and groups who are nutritionally at risk; (2) determination of interventions appropriate to alter nutrition status; and (3) monitoring of interventions

  
• Nutritional assessment can be applied throughout the various stages of the life cycle

  
• Nutritional assessment may be carried out at different levels (individual, regional, community, or national)

  
• Nutritional assessment is the first step in nutrition program planning and management
• Nutritional assessment is the first step in nutrition care process
• Why is nutritional (status) assessment important?

  • It is a skill essential for nutritional epidemiologists, researchers, and clinical nutritionists involved in investigating links between diet and health
  • It increases knowledge of the relationship between nutrition, health, and chronic disease
  • It is central to current government efforts to monitor and improve the nutritional status of citizens

  
• Nutrition


  The intake of food, considered in relation to the body's dietary needs

  
• Good nutrition


  An adequate, well-balanced diet combined with regular physical activity – is a cornerstone of good health

  
• Poor nutrition


  Can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity
• Optimal Nutritional Status


  Relationship of Food to Health

  
• Type I nutrient deficiency


  The body's physiological response is to stop growing and repairing tissue to conserve the nutrient

  
• Type II nutrient deficiency


  The body's physiological response is to break down its own tissues to make the nutrient available, and other Type II nutrients are lost in the process
• Generalized Scheme for the Development of a Nutritional Deficiency

  1. Dietary inadequacy

  2. Decreased level in reserve tissue store

  3. Decreased level in body fluids

  4. Decreased functional level in tissues

  5. Decreased activity of nutrient-dependent enzyme

  6. Functional changes

  7. Clinical signs/symptoms

  8. Anatomical signs

  
• Methods of nutritional assessment

  • Direct methods: Anthropometry, Biochemical (Laboratory), Clinical assessment, Dietary assessment
  • Indirect methods: Ecological factors, Health and vital statistics

  
• Anthropometry


  Measurement of physical dimensions and gross composition of the body
• Anthropometry


  • Height, weight, head circumference, skinfold thickness
• Biochemical (Laboratory)


  Measurement of a nutrient or its metabolite in blood, feces, urine, and other tissues
• Biochemical (Laboratory)


  • Hemoglobin level, cholesterol level
• Clinical


  Physical examination and/or medical history to detect signs and symptoms of malnutrition
• Clinical

  • Sign of iodine deficiency - enlarged thyroid gland; symptom of iron deficiency - fatigue
• Dietary


  Measurement of quantity of individual foods consumed during one to several days or pattern of food use
• Ecological


  The problem of malnutrition is a human ecological problem owing to the multiple overlapping and interacting factors in a community's physical, biological, cultural, and nutritive environments
• The amount of various food and nutrients available for an individual will depend on environmental conditions
• It is essential to make an ecological assessment of the various factors present in a community for identification of at-risk age groups and recommend appropriate nutrition interventions

  
• Aspects of ecological assessment

  • Socioeconomic factors
  • Food considerations: Availability, Accessibility, Preparation and processing methods, Consumption (food habits/beliefs), Utilization, Nutritional Adequacy
  • Aspects of health: Contributory infections, Environmental sanitation, Health-related services
  • Demographic issues
  • Political priorities
  • Cultural factors
  • Geographical and climatic influences

  
• Methods of obtaining ecological information

  • Background data: Library search, Secondary data from government, statistical bureau
  • Data collected: Observations, Rapid ecological visits, Home visits, Interviews using structured questionnaires