slides current until 2008 nutrition assessment. curriculum module iii-5 slide 2 of 25 activity...
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Slides current until 2008
Nutrition assessment
Nutrition assessmentCurriculum Module III-5
Slide 2 of 25ACTIVITY
Slides current until 2008
Identify the factors that influence
dietary intake.
Nutrition assessmentCurriculum Module III-5
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Assessment of health status /1
• Socio-economic status and culture
• Dental health
• Screening for co-morbidity, e.g. coeliac disease
Nutrition assessmentCurriculum Module III-5
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Assessment of health status /2
• Laboratory tests to determine clinical status
– fasting glucose, HbA1c level
– lipid profile (cholesterol — HDL, LDL)
– haemoglobin, ferritin, creatinine, U and E’s, thyroid function
• Screening for complications e.g. cardiovascular, renal disease
• Current medication and nutrient supplements
Nutrition assessmentCurriculum Module III-5
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• Body weight
• Height
• Agreed acceptable weight
– using standard height/weight tables
Anthropometric measurements
Nutrition assessmentCurriculum Module III-5
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Weight and height measurements to calculate BMI:
BMI = weight in kg/(height in m)2
Standard BMI normograms: 21-25 desirable
25-30 overweight
>30 obese
Geographical variations exist
Body Mass Index (BMI)
Nutrition assessmentCurriculum Module III-5
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Body Mass Index (BMI)
Calculate the individual BMI of your
fellow participants.
Nutrition assessmentCurriculum Module III-5
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Waist-to-hip ratio (WHR)
• Central adiposity – important cardiovascular risk marker
• High WHR – increased risk
• WHR used to define body shape
• A pear-shaped body is preferable to an apple-shaped body
Nutrition assessmentCurriculum Module III-5
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Measuring WHR
The hip circumference is the largest circumference at the posterior extensive of the buttocks
The waist circumference is the smallest circumference below the rib cage and above the umbilicus
Nutrition assessmentCurriculum Module III-5
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Central obesity
plus any two of the following four factors:
- raised triglycerides- reduced HDL cholesterol- raised blood pressure- raised fasting blood glucose
IDF definition of the metabolic syndrome
Nutrition assessmentCurriculum Module III-5
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Dietary assessment
• Dietary history
– usual food intake recorded through interview
• Dietary recall
– food and drink consumed in previous 24 hours (24-hour recall)
Nutrition assessmentCurriculum Module III-5
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Dietary history and recall tips
Ask for or check:
• Food pattern on a normal day
• Size of portions at home
• Daily/weekly/monthly purchases
• Eating out and take-away – frequency
• Food favourites – self and family
• Food products, e.g. skimmed or whole milk
• Hunger patterns
Nutrition assessmentCurriculum Module III-5
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Identify some disadvantages of
the dietary recall method
Nutrition assessmentCurriculum Module III-5
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• Food frequency questionnaire
• Prospective food records
• Weighed food records
Detailed dietary assessment methods
Nutrition assessmentCurriculum Module III-5
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Groups with special dietary needs
• Pregnant women
• People with a gastro-intestinal condition, such as coeliac disease
• Older people
Nutrition assessmentCurriculum Module III-5
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Interpreting assessment data
Analyse the information collected from the
assessment process
What further considerations are necessary
before the management plan is agreed on?
Nutrition assessmentCurriculum Module III-5
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Summary
• Detailed assessment
• Multiple factors for assessment
• Variety of assessment methods
• Special groups
Nutrition assessmentCurriculum Module III-5
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Giving nutrition education to people
without first analysing their nutritional
and health status is like sailing a ship in a
fog without a compass, charts or
information about the weather and
currents.
Nutrition assessmentCurriculum Module III-5
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Review question
1. Which of the following is NOT a goal of nutritional assessment?
a. To identify malnutrition (under and overweight)
b. To identify those at risk of nutritional deficiencies
c. To identify eating habits that may be associated with poor diabetes control and increased risk of cardiovascular disease
d. To allow people to choose their own treatment plan
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Review question
2. In European populations, which BMI is classified as obese?
a. 24
b. 26
c. 28
d. 31
Nutrition assessmentCurriculum Module III-5
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Review question
3. When describing central adiposity, which fruit shape is associated with an increased risk of cardiovascular disease?
a. Apple
b. Pear
c. Orange
d. Melon
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Review question
4. Which of the following is NOT included in the IDF definition of the metabolic syndrome?
a. Raised fasting blood glucose
b. Raised blood pressure
c. Reduced LDL cholesterol
d. Raised triglycerides
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Review question
5. Which of the following is NOT used to assess diet in normal clinical practice
a. Food diaries
b. Weighed food records
c. Diet histories
d. Diet recall
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Answers
1. d
2. d
3. a
4. c
5. b
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References
1. American Diabetes Association. Diabetic Nephropathy. Diabetes Care 2004; 27(suppl 1).
2. American Diabetes Association. Dyslipidemia Management in Adults with Diabetes. Diabetes Care 2004; 27(suppl 1): S68-71.
3. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2004; 27(suppl 1): S19.
4. Anil Kapur, et al. Novovare Interactive Nutrition Assistant - A computer aided Interactive Nutrition Management Program, Novo Nordisk. Diabetes Update Proceedings 1997.
5. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2003; 27(suppl 2): S19.
6. International Diabetes Federation. www.idf.org
7. Maryniuk MD. The new shape of medical nutrition therapy. Diabetes Spectrum 2000; 13(3): 122-24.