Assessment of Nutritional Status Learning Objectives: To undersatand the basic anthropometric techniques and applications. Introduction The nutritional status of an individual is often the result of many interrelated factors. Nutritional Assessment Why? The purpose of nutritional assessment is to Identify individual or population groups who are malnourished. Identify individual or population groups at risk of becoming malnourished. To develop health care programmes that meet the community needs which are defined by the assessment. To measure the effectiveness of the nutritional programmes and intervention once initiated. Methods of Nutritional Assessment Direct and Indirect Direct methods of nutritional assessment: These are summarized as ABCD. Indirect method of nutritional assessment These included three categories. Clinical assessment It is the simplest and most practical method of ascertaining the nutritional status of a group of individuals. Detection of relevant signs helps in establishing the nutritional diagnosis. Clinical Assessment Advantage Fast and easy to perform Inexpensive Non Invasive Limitations. Clinical Signs of nutritional deficiency Anthropometric methods Anthropometry is the measurement of body height, weight and proportions. Other anthropometric measurements Mid arm circumferences Skin fold thickness Head circumference Head/ Chest ratio Hip/ Waist ratio Anthropometry for children Accurate measurement of height and weight is essential. The results can then be used to evaluate the physical growth of the child. Measurement of adults Height: The subject stands erect and bare footed on a stadiometer with a movable head piece. The head piece is leveled with skull vault and height is recorded to the nearest 0.5 cm. Nutritional Indices in adults The international standards for assessing body size in adults is the body mass index.(BMI) BMI is computed using the following formula. BMI = Weight (Kg)/ Height (met)2 BMI ( W.H.O Classification) BMI < 18.5 = Underweight BMI 18.5 – 24.5 = Healthy weight range BMI 25 – 30 = Overweight ( Grade 1 obesity) BMI > 30 – 40 = Obese ( Grade 2 obesity) BMI > 40 = very obese ( morbid or grade 3 obesity) Advantages of anthropometry Objective with high specificity and sensitivity. Readings are numerical and gradable on standard groth charts. Limitations of anthropometry Inter observers errors in measurement. Limited nutritional diagnosis. Problems with reference standards i.e local verus international standards. Dietary Assessment Nutritional intake of human is assesses by five different methods. These are 24 hours dietary recall. Food frequency questionaire. Dietary history since early life. Food dairy technique. Observed food consumption. Initial laboratory assessment Hb estimation is the most important test and useful index of the overall state of nutrition. Specific lab tests Measurement of individual nutrient in body fluids( e.g serum reinol, serum iron, urinary iodine, vit D) Detection of abnormal amount of metabolites in urine ( e.g urinary creatinine / hydroxy proline ratio) Analysis of hair, nails and kin for micronutrients. Advantages of biochmical method It is useful in detecting early changes in body metabolism and nutrition before the appearance of overt clinical signs. It is precise, accurate and reproducible. Limitations Time consuming expensive. About the Author:

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