Assessment of Nutritional Status
Outline
• Introduction
• Definition of nutritional assessment
• Importance of nutritional assessment
• Methods of Nutritional Assessment
• Factors affecting in food choices
Introduction
Nutritional status is the condition of health of the individual as
influenced by the utilization of the nutrients. It can be determined by
correlation of information obtained through
 medical and dietary history,
 physical examination
 laboratory investigation.
Importance of nutritional assessment; Nutritional assessment aids
in identifying
a) Under Nutrition
b) Over Nutrition
c) Nutritional deficiencies
d) Individuals at the risk of developing malnutrition
e) Individuals at the risk of developing nutritional related diseases
f) The resources available to assist them to overcome nutritional
problems.
The nutritional status can be assessed by the following methods:
I. Direct Methods
a) Nutritional Anthropometry
b) Clinical Examination
c) Biochemical tests and
d) Biophysical methods.
II Indirect Methods
a) Vital statistics of the community
b) Assessment of socio – economic status and
c) Diet surveys
Measurements used to evaluate nutritional statues:
1. History of dietary intake:
 Where and when food is eaten.
 Use of dietary supplements.
 Food resources Special diet, if any Cooking facilities
 24-hour recall
o All foods & beverages
o Time of day eaten
o Amounts consumed
o Food preparation
o Typical day?
 Food record
o Recorded over several days
o Recorded as consumed
o Does not rely on memory
 Direct observation
o Calorie counting
o Time consuming
2. Biochemical Measurements:
 Blood vitamin levels.
 Blood protein levels.
 Blood lipid levels
3. Anthropometric measurements:
 Height: Adults
 Length for infants and < 24
months
 Head circumference to
assesses brain development
< 3 years of age
 Skinfold thicknesses.
Waist circumferences to evaluate

body fat
 Body Mass Index (BMI)= body weight(kg)÷height (meter)2
 Wasting or under nutrition
 Normal BMI is 20-25 kg/m2
BMI less than 18.5 kg/m2
 Over weight. 25 -30 kg/m2
 Moderate obesity. 30 -35 kg/m2
 Sever obesity- 35 –40 g/m2
 Morbid obesity over 40 kg/m2
4. Clinical assessment ; Clinical Signs of Nutritional
Statues
Features
Good nutritional statues
Bad nutritional statues
General appearance Alert and responsive
Listless and apathetic
Hair
Shiny and healthy scalp
Brittle and dry.
Neck glands
No enlargement
Thyroid enlarged.
Skin, face and neck
Smooth and slightly moist
Greasy and scaly.
Lips
Bright, clear, no fatigue
Dryness, infection signs
Tongue
Good color, moist
Dry and swollen.
Gums
Good pink color and no lesions
Redness or swelling.
Teeth
Good pink color, no swelling or
Unfilled cavities, absent
bleeding, no crowding, wellshaped jaw and no discoloration
teeth, worn surfaces and
mal positioned
Abdomen
Flat
Swollen
Legs and feet
No tenderness, no weakness and
no swelling
Tender, weak and swollen.
Skeleton
No malformation.
Bow legs and chest
deformity.
Weight
Normal for height, age, body
build
Over or underweight.
Posture
Erect, arms and legs straight,
abdomen in, chest out
Sagging shoulders, sunken
chest, humped back
Muscles
Well-developed, firm.
poor tone and undeveloped
Nervous control
Good attention span, does not cry
easily not irritable or restless.
Inattentive and irritable.
Gastrointestinal
functions.
Good appetite and normal
digestion, regular elimination
Anorexia, indigestion,
constipation or diarrhea
General vitality.
Endurance, energetic, sleeps well
at night and vigorous
Easily fatigued, no energy,
looks tired and apathetic.
Factors affecting in food choices:
1) Habit: People sometimes select foods out of habit. They eat
cereal every morning, for example, simply because they have
always eaten cereal for breakfast. Eating a familiar food and
not having to make any decisions can be comforting.
2) Ethnic
Heritage or Tradition:
Among the
strongest
influences on food choices are ethnic heritage and tradition.
People eat the foods they grew up eating. Every country, and
in fact every region of a country, has its own typical foods and
ways of combining them into meals.
3) Social Interactions: Most people enjoy companionship while
eating. It's fun to go out with friends for pizza or ice cream.
Meals are social events, and sharing food is part of hospitality.
Social customs invite people to accept food or drink offered by
a host or shared by a group.
4) Availability, Convenience, and Economy: People eat foods
that are accessible, quick and easy to prepare, and within their
financial means.
5) Positive and Negative Associations: People tend to like
particular foods associated with happy occasions-such as hot
dogs at ball games or cake and ice cream at birthday parties. By
the same token, people can develop aversions and dislike foods
that they ate when they felt sick or that were forced on them.
6) Emotional Comfort: Some people cannot eat when they are
emotionally upset. Others may eat in response to a variety of
emotional stimuli-for example, to relieve depression or to calm.
A depressed person may choose to eat rather than to call a
friend.
7) Values: Food choices may reflect people's religious beliefs,
political views, or environmental concerns.
8) Body Weight and Image: Sometimes people select certain
foods and supplements that they believe will improve their
physical appearance and avoid those they believe might be
detrimental. Such decisions can be beneficial when based on
sound nutrition and fitness knowledge.
9) Nutrition and Health Benefits: Many consumers make food
choices that will benefit health.
10) Culture:
foods.
According to culture people choose certain types of