NUTRITION

Nutrition is important to maintain health

and to prevent diseases and death.

When illness and injury occurs optimal

nutrition is essential for healing and

resisting infection and other complications

SCREENING

•To determine nutritional health

•Look for warning signs

•Maintain optimal health of healthy

persons

•Identify risks to medical treatment and

recovery

COMPONENTS OF NUTRITIONAL

ASSESMENT

•Identify stages in the development of deficiency disease•A = ANTHROPOMETRIC MEASUREMENTS•B = BIOCHEMICAL ANALYSIS•C = CLINICAL INFORMATION•D = DIETARY INFORMATION•E = EVALUATION/ENVIRONMENT

Assessment

•past medical history• family history• social history

Past Medical History

• Immunizations, hospitalizations, operations, major injuries, chronic illnesses, and significant acute illnesses • Current or recent prescription medications, vitamins

and minerals, laxatives, topical medications, OTC medications, and nutritional supplements • Potential drug-nutrient interactions, such as those

caused by potassium-wasting diuretics • Food allergies or lactose intolerance

Family History

• Family history of cancer, diabetes, heart disease, hypertension, obesity, and osteoporosis • Parents, siblings, children, spouse: include ages,

current health status, and cause of death if deceased

Social History

• Occupation, daily exercise pattern, marital and family status • Economic status, educational level, residence,

emotional response to illness and coping skills • Duration and frequency of use of substances,

including tobacco, alcohol, illegal drugs, and caffeine

ANTHROPOMETRIC MEASURES

ANTHROPOMETRIC MEASURES

• Fatfolds – TSF (total subcutaneous fat) and total

body fat

• MAC – midarm circumference-muscle mass and

subcutaneous fat

• MAMC – midarm muscle mass/circumerence, skeletal

muscle

• BIA – lean body mass

1. Measure weight:

• Make sure the scale pointer is at zero before• taking a measurement.• The person is required to dress in lightclothes and take off shoes. Women shouldremove scarf.• He/she must stand straight and unassistedon the centre of the balance platform.• The weight should be recorded to the nearest 0.1kg.

2. Measure height:

• The person is required to remove his/her shoes, stand erect, looking

straight in a horizontal plane with feet together and knees straight.

The heels, buttocks, shoulder blades and the back of the head should touch against the wall.

3. Calculate Body Mass Index (BMI):

• Convert cm to meters ( 1 metre = 100 cm)

• Calculate BMI using this formula:BMI = Weight in kilograms

(Height in m)2

BMI references:

<18.5 = Underweight18.5-24.9 = Normal weight25-29.9 = Overweight30 and above=Obese

BIOCHEMICAL ANALYSISITEM ELEVATED DECREASEDAlbumin Dehydration Edema, Ca, ESRDBUN Renal failure

DehydrationHepatic failureMalnutrition

Na Dehydration, coma Edema, burns, diarrhea, vomiting

Creatinine Renal diseaseFerritin Renal disease

Inflammatory disFe def anemia

FBS DM, drugs, MI, Kdeficiency,

Insulin overdose,ETOH

Biochemical testing contribute to diagnosing micronutrient deficiencies. The most common deficiencies are: Iron vitamin A, andIodine During emergencies:scurvy Beriberi (vitamin B 1 deficiency)pellagra (vitamin B 3 deficiency).

DIETARY INFORMATION

• Nutrition history -• Special diet order – compliance• Relate diet to disease state• Appropriateness• Meeting nutritional needs• Food/drug interactions: antibiotics, anticonvulsants,

etc.

EVALUATION/ENVIRONMENT

• Summary of findings• Recommendations• Potential problems• Socioeconomic concerns• Psychosocial concerns• Adequate housing• Disease state affects ability to prepare food• Adequate food, storage, equipment to prepare food

Generic Nutrition Questionnaire

• Would you describe you appetite as hearty, moderate, or poor? • Are you on a special diet? Specify the type of diet.

Who recommended the diet? If you have been on a special diet in the past, define it. • Have you ever had any problems with weight?

Underweight or overweight? • Do you eat at approximately the same time every

day?

• Do you skip meals? If so, when? • Do you usually eat between meals? What do you

snack on most often? • Are there any foods you do not eat because you don’t

think they are good for you? If yes, what?

• Are there any foods you do eat regularly because you think they are good for you? If yes, what? • Are there any foods you cannot eat? What happens

when you eat this food? • Are there foods you avoid because you don’t like

them? • How is your food usually prepared, e.g. baked,

broiled, fried?

• Are you on a diet now to lose or gain weight? If yes, what kind? Who recommended it? • How do you feel about your weight? • Are you taking any vitamin or mineral supplements?

What and how often?

•Do you smoke? How many cigarettes (cigars or chewing tobacco) per day?

• How many hot meals do you eat per week?

•What condiments do you use? Examples include butter on bread, sugar on cereal, salad dressing, gravy, etc.