ABCD's of Nutritional Assessment

Undernutrition

Under nutrition is a condition which occurs when there is lack of adequate energy, protein and/or micronutrients (like iron, vitamin A etc.) in the diet.

Undernutrition

Overnutrition

Overnutrition

Body Mass Index (BMI)

Body Mass Index

Mid-Upper Arm circumference (MUAC)

Mid-Upper Arm circumference (MUAC)

The arm circumference can be measured using flexible fibre glass tape

and can be interpreted as under:

MUAC less than 110mm (11.0cm), indicates Severe Acute Malnutrition (SAM).

The child should be immediately referred for treatment.

MUAC of between 110mm (11.0cm) and 125mm (12.5cm), indicates Moderate

Acute Malnutrition (MAM). The child should be immediately

referred for supplementation.

MUAC of between 125mm (12.5cm) and 135mm (13.5cm),

indicates that the child is at risk for acute malnutrition and should be counseled

and followed-up with Growth Monitoring..

MUAC over 135mm (13.5cm), indicates that the child is well nourished.

Skin-fold Thickness

Skin-fold Thickness

Skinfold measurement, therefore, is a simple means of measuring

subcutaneous fat i.e. fat under the skin, which is also known a

skinfold thickness and is indicative of fat or fat reserves in the body.

Fat fold can be measured at triceps (muscle found in the upper

arm region), biceps, subscapular or suprailiac region. 2.5mm (men) or about 20% fat; 18.0mm (women) or about 30% fat.

Body Circumference

Body Circumferences

Waist circumference (WC) as a tool is used to assess abdominal fat and health status primarily in adults. WC predicts risk over and above that of BMI regarding which we learnt earlier. Waist is measured around the navel in a standing position using a flexible Non-stretchable tape..

Head Circumference

Head Circumference

The average total head circumference growth from birth to 3 months is equal to 5 cm (1.97 in.), and 4 cm (1.57 in.) average from 3 to 6 months. This trend continues to decelerate across the first year; between 6 and 9 months, head circumference increases 2 cm (0.79 in.)

Arm Span & Knee Height

Arm Span & Knee Height

Recumbent Bed Measurement

Recumbent Bed Mesurement

Blood Tests

Blood

Tests

Urine Tests

Urine

Test

Physical Appearances

Physical Appearance

Physical Appearances

Physical Appearance

Physical Appearances

Physical Appearance

Questions

Calculate the body mass index (BMI) for a patient whose height is 1.75 m and whose

is 99 kg.

a) 29 b) 32 c) 39 d) 43

The following clinical findings can be used to make a formal diagnosis of malnutrition except:

a. Insufficient food intake

b. Fluid accumulation

c. Loss of muscle mass

d. Presence of bed sores

e. Decrease in grip strength

What do you mean by A,B,C,D's of Nutritional Assessment?

Which of the following are not data that should be collected during a nutrition assessment?

a. Family nutrition history

b. Anthropometric measurements

c. Biochemical data

d. Physical exam information

e. Food and nutrition patient history

Which of the following is true regarding a nutrition assessment?

a. All admitted patients should receive a nutrition assessment

b. The assessment should utilize a standardized tool

c. The assessment should be led by a nurse or nurse practitioner

d. Limited patient/family caregiver involvement should be required

Questions

Which of the following commonly result from malnutrition:

a. Weight loss

b. Falls

c. Hospital-acquired infections

d. Pressure ulcers

e. All of the above

A food contains 5 grams of carbohydrate, 10 grams of fat and 5 grams of protein. How many Calories (kcal) does this food provide?

a. 20 b.80 c. 105 d. 130 e.180

True or False

MUAC less than 12.5 com indicates well nourished child.

A low Weight-for-height is indicative of Stunting.

BMI range between 18.5 to 24.9 indicates normal weight.

WHR leass than 0.85 among women is indicative of abdominal obesity.

Clinical assessment deals with assessment of constituents in body fluids like blood and urine.

Nutrient deficiencies can lead to sign and symptom which can help diagnose malnutrition.

24-hour recall method of dietary assessment is useful at an individual level.

Questions

Fill in the blanks

1. Malnutrition refers to both --------------------------- and-------------------------------- .

2. The study which emphasizes the application of food and nutrition knowledge to the improvement of health and well being of individuals is is called--------------------------------

3. Abnormal or excessive fat accumulation that present a risk to health is called-----------------.

4. Diet inadequate in terms of the nutrient iron can lead to the deficiency condition called------- .

5. -------------- and ------------------ are the immediate causes of malnutrition.

1. Overweight is a consequence of:

a) deficiency of one or more nutrient b) infections c) excessive intake of energy d) Both b and c

2. Underlying causes of malnutrition include:

a) Political factors b) Illness and Disease c) Inadequate care for women and children d)Economic factors

3. Consequences of malnutrition include:

a) Lowered immunity b) Poor productivity c) Poor growth d) All of the above

4. Non communicable diseases are consequences of:

a) Infections b) Lowered immunity c) Poor cognition d) Overnutrition

5. Diabetes, Hypertension are an example of:

a) Infectious disease b) Non communicable disease c) Deficiency disease d) None of the above

Questions

Fill in the blanks

1. The RDA for energy is expressed as ----------------------- .

2. During periods of physiological stress such as during pregnancy and lactation the requirement for

energy and protein is given as ---------------------- intake.

3. In infancy RDA for energy, protein etc is expressed as per kg ------------------------ .

4. RDA for adults are based on sex, body weight and ----------------- .

5. Nutrient requirement is the ------------------------- amount that needs to be consumed to prevent

symptoms of deficiency and maintain satisfactory level of the nutrient in the body.

6.----------------------- is added to the nutrient requirement to cover for variations in requirement from

individual to individual

7. RDA's are basically --------------------------- plus safety margin.

8. .RDA is the average daily nutrient intake sufficient to meet the nutrient requirement of nearly ---------

percent of healthy individuals in a particular life stage and gender group.

9. In India the RDA's are provided by ------------------------------------------------- .

10. RDA's apply only to ---------------------- people and not to people suffering from --------------------- .

Questions