“Nutritional assessment is the systematic process of collecting and interpreting information in order to make decisions about the nature and cause of nutrition-related health issues that affect an individual.”
(British Dietetic Association (BDA), 2012)
- The nutritional status of an individual is often the result of many inter-related factors.
- It is influenced by food intake, quantity and quality, and physical health.
- The spectrum of nutritional status spread from obesity to severe malnutrition.
1. Nutritional assessment vs. nutritional screening
Nutritional screening – “a process to identify an individual who is malnourished or who is at risk for malnutrition to determine if a detailed nutrition assessment is indicated.”
Nutritional assessment – “a comprehensive approach to diagnosing nutrition problems that uses a combination of the following: medical, nutrition, and medication histories; physical examination; anthropometric measurement; and laboratory data.”
2. Methods of Nutritional Assessment
Direct methods – Deal with the individual and measure objective criteria
Includes – Anthropometry
Biochemical
Clinical
Dietary evaluation methods
Indirect methods – Use community health indices that reflects nutritional influences.
3. Nutritional screening key criteria
- Anthropometrics: weight, length/height, BMI
- Growth measures < than 5th percentile
- Growth measures > than 90th percentile
- Alterations in growth patterns
- Change in Z-scores
- Change 1-2 SD
- Change percentiles
- Medical and developmental Conditions
- Medications
- Improper or inappropriate food/formula choices or preparation
- Psychosocial
- Laboratory Values
4. Commonly used nutrition screening tools
Now let’s talk about the direct Methods of Nutritional assessment
Direct methods – Deal with the individual and measure objective criteria
1. Anthropometry – Refers to the measurement of the human individual. This includes taking your height, weight, waist circumference, and other body measurements to assess your body composition and identify any risk factors for malnutrition or chronic diseases.
2. Biochemical – Refers to the use of laboratory or biochemical data acquired through blood and urine samples to evaluate an individual’s nutritional status.
Below are commonly used diagnostic criteria for assessing individual’s biochemical parameters
| Test | Intermediate Hyperglycemia(“Prediabetes”) | Diabetes |
| Fasting glucose | 100-125 mg/dL (6.1-7.0 mmol/L) | ≥126 mg/dL (7.0 mmol/L) |
| OR 2-hour glucose following ingestion of 75-g glucose load | 140-199 mg/dL (7.8-11.0 mmol/L) | ≥200 mg/dL (11.1 mmol/L) |
| OR random plasma glucose in symptomatic | ≥200 mg/dL (11.1 mmol/L) patient | |
| OR HbA1c | ≥6.5% (48 mmol/mol) | |
| Fasting is defined as no caloric intake for at least 8 hours. The HbA1c test should be performed in a laboratory using a NGSP-certified method and standardized to the Diabetes Control and Complications Trial assay. The 2-hour postprandial glucose test should be performed using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water. | ||
Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and your blood vessels and lead to plaque buildup.
Most adults should have their blood pressure checked at least once a year. If you have high blood pressure, you will likely need to be checked more often.
| Blood Pressure Category | Systolic Blood Pressure | Diastolic Blood Pressure |
| Normal | Less than 120 | Less than 80 |
| High Blood Pressure (no other heart risk factors) | 140 or higher | 90 or higher |
| High Blood Pressure (with other heart risk factors) | 130 or higher | 80 or higher |
| Dangerously high blood pressure – seek medical care right away | 180 or higher | 120 or higher |
| Parameter values | Recommended level |
| LDL cholesterol <100 100 – 129 130 – 159 160 – 189 = 190 | Optimal Near optimal/ above optimal Boderline high High Very high |
| Total cholesterol <200 200 – 239 = 240 | Desirable Borderline high High |
| HDL cholesterol <40 =60 | Low High |
| Triglycerides <150 150 -199 200 – 499 = 500 | Normal Borderline high High Very high |
3. Clinical – A physical examination, or clinical examination is the process by which a medical professional investigates the body of a patient for signs of diseases. Visible aspects of general body composition include an evaluation of general muscle, fat mass, and fluid status.
4. Dietary evaluation methods – A dietary assessment is a comprehensive evaluation of a person’s food intake. This includes 24hr recall, food frequency questionnaire, dietary history, 3 day diet diary, weight food record and observed food consumption.
5. The Nutrition care process
The Nutrition Care Process is a standardized problem-solving approach in which practitioners use critical-thinking skills to make evidence-based decisions addressing the nutrition-related problems of their clients/patients.
