overview

• 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


  Represents the ideal state of nutrition where the body's nutritional needs are fully met
• Nutritional deficiencies


  • Can be categorized as Type I or Type II according to the physiological responses of the body to dietary deficiency
  • With Type II nutrient deficiency, the response is for the body to stop growing and repairing tissue to conserve the nutrient, or even to break down its own tissues to make the nutrient available. 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 (can be observed) of iodine deficiency - enlarged thyroid gland; symptom (can be felt) 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 therefore 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