General Health

Methods of Evaluating Nutritional Status

Nutritional assessment is the examination of anthropometric, biochemical (laboratory), clinical and dietary data to determine whether an individual or groups of people are well-nourished or malnourished (overnourished or under-nourished). Nutritional assessment can be done using the following methods:

  • Anthropometry
  • Dietary methods
  • Clinical methods
  • Biochemical/biophysical methods

Anthropometry

The word anthropometry is composed of two words: Anthropo means ‘human’ and metry implies measuring. In any community, one will be able to utilise anthropometric measurements to estimate either growth or change in the body composition of the population. The many metrics took to determine growth and body composition are presented below.

Cut-off values for BMI for measuring adult nutritional status.

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Dietary method

Dietary methods of assessment include looking at previous or current intake of nutrients from the food by individuals or a group to establish their nutritional status. One can inquire what the family or the mother and the child have eaten over the past 24 hours and use this data to construct the dietary diversity score. Dietary diversity is a measure of the number of food types consumed over a reference period, usually 24 hours or one day. Generally, there are six food types that the body needs every day. This is reflected in the food guide pyramid:

  • Prospective food record – Food diary for at least a week. It is suitable for individual studies. It should include meals consumed, fluids and supplements taken, and any artificial feeds.
  • 24-hour recall – Write down what has been consumed in the last 24 hours by an individual. It is more reliable for group studies, rather than individual studies.
  • Food frequency – A questionnaire is usually used to see how a group of people eat. It is ideal for group and population investigations.

Clinical Methods

As a public health professional delivering health services at the community level, one will probably certainly encounter numerous persons with nutritional deficiency concerns. In addition to the anthropometric tests, one can also access clinical signs and symptoms that might indicate a potential specific nutrient shortage. Clinical ways of measuring nutritional status involve checking indicators of insufficiency at specific sites on the body or asking the patient whether they have any symptoms that would imply nutrient shortage from the patient. Clinical indications of nutritional shortage include pallor (on the palm or the conjunctiva of the eye), Bitot’s spots on the eyes, pitting oedema, goitre and severe apparent wasting.

Checking bilateral pitting oedema in a child

To determine the existence of oedema, one should apply normal thumb pressure on both feet for three seconds (count the numbers 101, 102, and 103 to estimate three seconds without using a watch) (count the numbers 101, 102, and 103 to estimate three seconds without using a watch). If a shallow print persists on both feet, then the baby has nutritional oedema (pitting oedema) (pitting oedema). one must test for oedema with finger pressure.

Grades of oedema

Depending on the existence of oedema on the different levels of the body it is graded as follows. An increase in grades suggests an increase in the severity of oedema.

  • Absent
  • + (Mild) Both feet/ankles
  • ++ (Moderate) Both feet, plus lower legs, hands or lower arms
  • +++ (Severe) Generalised bilateral pitting oedema, including both feet, legs, arms and face

Biochemical methods

Blood

  1. Erythrocytes and Haemoglobin
  2. Lipids and Cholesterol
  3. Proteins
  4. Vitamins and minerals

Urine

  1. Nitrogen
  2. Urea
  3. Selected minerals and vitamins

Stool

  1. Culture
  2. Metabolites

Xenobiotic (xenobiotic is a chemical compound found within an organism that is not naturally produced or expect to be present within the organism) load in body fluids, stool, nails and hair.

References

  1. https://www.physio-pedia.com/Edema_Assessment#:~:text=The%20grading%20of%20edema%20is,visible%20distortion%20that%20rebounds%20immediately.
  2. https://www.wikilectures.eu/w/Nutritional_Status_Assessment

Author

 Yash Batra

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