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Lecture 2b
13 Jan. 2014
Nutritional assessment
Nutritional assessment includes:
•Health, drug, personal and diet histories
•Anthropometric measurements
•Laboratory tests
•Physical examination
Health, drug, personal and diet histories
Health history
-The need for diet modifications including weight
reduction
-Potential health problems that modified diets
might help to prevent or delay
-Symptoms and clinical findings that can affect
food intake or alter nutrient needs
-Disorders and treatments that demand a great
deal of time, motivation or financial resources
-Physical disabilities that interfere with a person’s
ability to purchase, prepare, and/or eat adequate
amounts of food
Health, drug, personal and diet histories
Medication history
All prescription and over the counter (OTC)
including doses and dose frequency
Nutrient and herbal supplements-types, amounts
and number of times taken
Health, drug, personal and diet histories
Personal history
Intellectual, spiritual, social, physical,
psychological and financial factors affecting
nutritional status
Health, drug, personal and diet histories
Diet history
How much of what a person is eating
Health, drug, personal and diet histories
Diet history
Do you have favourite foods?
Do you dislike any foods?
Are there any foods you do not eat for any reason?
Are you allergic or intolerant to any foods?
Are you on a special diet?
How many times a day do you typically eat meals
and snacks?
How many times do you typically eat out?
How is your appetite?
Who does grocery shopping in your household?
Diet History continued
-24 hour recall- everything eaten and consumed in
last 24 hours
-food frequency questionnaire-how many servings
of each food group in a typical day, week or
month
Diet History continued
-food records- the patient’s food records
recorded by patients-records are maintained over
several days as well as a person’s response and
compliance with medical nutrition therapy or
tolerance for foods- such records may include
patient’s mood when eating, symptoms associated
with eating, what the patient was doing while
eating, and physical activity records,
administration of medications, and illness.
Anthropometric measurements
-length, height, weight-infants and children
-head circumference-infants
-children- 2 and over- height and weight used
to calculate BMI
-adults-BMI, waist circumference
-ibw and ubw- page 582 -3 in Rolfes et al
9th edition
Laboratory tests
-serum protein-protein intake status (PEM)
and body’s metabolism,
degradation and distribution
of the specific protein
-albumin-slow to respond to nutritional status
-detects state of hydration
-serum transferrin-protein energy intake and
iron intake
-transthyretin-rapidly drop and increase
(PEM)
-retinol binding protein-see transthyretin
-total lymphocyte count-pem –immune
response
Laboratory tests of blood plasma or serum
-cholesterol- up with saturated fatty acids
(sfa),trans
- down with polyunsaturated
fatty acids (pufa)
-triglycerides-down with oleic acid, up with
saturated fats and obesity
-HDLc-up with pufa down with trans
-LDLc-up with saturated fatty acids (sfa), trans
down with polyunsaturated
fatty acids (pufa)
-blood glucose-up with obesity-relationship to
above
Physical examination
Looking for signs of nutrient deficiency and
toxicity
-hair
-skin
-eyes
-posture
-tongue
-gums
-fingernails
Fig. 1-8, p. 22