ASSESSMENT OF NUTRITIONAL STATUS - UG.ppt

ASSESSMENT OF
NUTRITIONAL
STATUS
DEPARTMENT OF COMMINITY MEDICINE

QUESTION
 Describe the methods of nutritional assessment
in under-fives?
 Describe the methods of assessment of
nutritional status of a community with their
merits and demerits.

INTRODUCTION
 Life can not be sustained without adequate
nourishment.
 Human beings need adequate nutritients for
growth, development and to lead active and
healthy life- means good nutrition is the basis
for good health.
 How to assess that individual is on good/bad
nourishment?

 In India, 1-2 % of the pre-school children are
suffering from PEM.
 73 % and 81% of the children less than 3
years in urban and rural area are suffering from
nutritional anemia.
 HOW WE GOT THIS INFORMATION?
“ASSESSMENT OF NUTRITIONAL
STATUS”

WHAT IS NUTRITIONAL
STAUS?
 “The condition of health of a individual
which is influenced by the intake (quantity
and quality) and utilization of nutrients.”
 Normal nutritional status
 Malnutrition
 Nutritional status of a community is sum of
nutritional status of individual who forms that
community.

WHAT IS ASSESSMENT OF
NUTRITIONAL STATUS?
 It is a comprehensive evaluation of nutritional
status of an individual or group based
Anthropometry, Bio-chemical examination,
Clinical examination, Diet survey, Ecological
studies, Functional status assessment, Vital
and health statistics.

OBJECTIVES OF
NUTRITIONAL ASSESSMENT
To identify individuals or population groups at
risk of malnutrition.
To identify individuals or population groups
who are malnourished.
To develop nutritional programs to meet the
needs which are defined by the assessment.
To measure the effectiveness (evaluation) of
the nutritional programs.

Methods of Nutritional Assessment
Direct methods Indirect methods
1. Clinical examination
2. Anthropometry
3. Biochemical and
Laboratory
evaluation
4. Functional assessment
1. Assessment of
dietary intake
2. Vital and health
statistics
3. Ecological studies
8

CLINICAL EXAMINATION
 Clinical examination is the most essential part
of the nutritional assessment because the
ultimate objective is to assess the level of
health of individual as influenced by diets
they consume.
 Clinical signs are based on the examination
to find out changes related to inadequate or
excessive nutritional intake, that can be
observed in superficial tissues (skin, eyes,
hair, mouth) or in organs close to the
surface (thyroid).

Bitot spots
Vitamin A
deficiency Iron deficiency
Cojunctival pallor Angular stomatitis
Riboflavin deficiency
Spongy & bleeding gums
Enlarged thyroid Castle’s necklace
Vitamin C deficiency Iodine deficiency Niacin deficiency
10

MERITS AND DEMERITS
 Merits
Quick and easy to perform
Inexpensive
Non-invasive
 Demerits
Not possible to detect early cases
Diagnosis is made by experts only

ANTTHROPOMETRY
 Nutritional anthropometry is the measurement
of composition of the human body to assess
nutritional status.
 It is based on the principle that appropriate
measurements should reflect any
morphological changes occurring due to a
significant physiological changes influenced
by dietary intake.

COMMON ANTHROPOMETRIC
MEASUREMENTS
1. Height
2. Weight
3. Mid Upper Arm Circumference (MUAC)
4. Head and chest circumference
5. Waist circumference
6. Skin fold thickness
7. Body fat measurement

MEASUREMENT OF HEAD AND
CHEST CIRCUMFERENCE

MEASUREMENT OF WAIST
CIRCUMFERENCE

MERITS AND DEMERITS
 Merits
Quick and easy to perform
Inexpensive
Non-invasive
 Demerits
Inter-observer variations
Transport of equipments

BIOCHEMICAL AND LABORATORY
EXAMINATION
 It is a measurement of individual nutrient in
the body fluids.
 Principle:Variations in the intake of
different nutrients in the diet is reflected by
changes in the concentration of
corresponding nutrients in the body fluids.
 It reveals subclinical status of nutritional
deficiency.

BIOCHEMICAL AND LABORATORY
EXAMINATION
Examples -
 Serum retinol
 Serum iron
 Urinary Iodine
 HB%
 RBC count
 Serum creatinine
 Blood urea

FUNCTIONAL STATUS
ASSESSMENT
 These are the tests to assess the degree of
alteration in the physiological functions
associated with malnutrition.
Examples:
 Capillary fragility - Vitamin C
 Prothrombin Time - Vitamin K
 Spermatogenesis - Zn

MERITS AND DEMERITS
 Merits
Accurate
Detect early changes
 Demerits
Expensive
Not possible to apply on large population
Needs expertise

ASSESSMENT OF DIETARY
INTAKE – DIET SURVEY
 Diet survey is an essential part of complete
study of nutritional status of individual or
group providing comprehensive information
on nutrient intake, sources of nutrient, food
habits and attitudes.
 It also provides information on social and
economic factors influencing food
consumption.

METHODS OF DIET SURVEY
1. Oral questionnaire Method (24 hours recall)
2. Inventory method
3. Food Frequency Questionnaire
4. Weighment of raw food
5. Weighment of cooked food

MERITS AND DEMERITS
 Merits
Detailed information on food intake
 Demerits
Recall bias
Under/over reporting of dietary intake

VITAL AND HEALTH
STATISTICS
 They provide additional information on
nutritional status of the community.
 It consists of mortality and morbidity data.
Mortality data:
Infant mortality rate
Under five mortality rate
Rate of LBW babies
Life expectancy

VITAL AND HEALTH
STATISTICS
Morbidity data: Hospital data and community
survey
PEM
Anemia
Xerophthalmia, other vitamin deficiencies
Endemic goiter
Diarrhea
Measles
Parasitic infestations

MERITS AND DEMERITS
 Merits
Helps to detect at risk group
 Demerits
Indirect method
Extent of contribution by malnutrition is not
possible to estimate.

ECOLOGICAL STUDIES
 Food balance sheet: It provides data on food
supplies related to census population to derive
levels of food consumption (per capita supply
and availability).
 Socio-economic factors: Family size,
occupation, income, education, customs, and
cultural patterns (related to food practices).

ECOLOGICAL STUDIE
 Health services: Primary health care services,
nutritional and immunization programmes.
 Conditioning influences: Infection and
malnutrition.

MERITS AND DEMERITS
 Merits
Helps to detect at risk group
 Demerits
Indirect method

NUTRITIONAL SURVEILLANCE
 “Keeping watch over nutrition, in order to
make decisions that will lead to
improvement in health status of the
population.”
 Strategies:
1. Identification of nutritional problems in the
community.
2. Analyze the cause of nutritional problems.
3. Select appropriate ways to tackle these
problems (Launching nutritional
Programmes).

SUMMARY
 Human beings need adequate nutritients for
growth, development and to lead active and
healthy life,
 It is a comprehensive evaluation of nutritional
status of an individual or group based
Anthropometry, Bio-chemical examination,
Clinical examination, Diet survey, Ecological
studies, Functional status assessment, Vital
and health statistics.

ASSESSMENT OF NUTRITIONAL STATUS - UG.ppt

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ASSESSMENT OF NUTRITIONAL STATUS - UG.ppt