NS 210 Unit 9
Seminar: Review for
Final Project
Jennifer Neily, MS, RD, CSSD, LD
Kaplan University
Final Project
Behavioral Risk Factor
Surveillance System (BRFSS)
State based system of health surveys
that collect information on health risk
behaviors, preventive health practices
and health care access primarily
relate to chronic disease and injury
 Use the CDC website to gather
information/statistics in your area

Nutritional Screening

Nutritional Screening


the process of identifying
characteristics know to be associated
with nutrition problems.
Nutrition Assessment is the first of
four steps in the Nutrition Care
Process.
Nutrition Assessment
Methods

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Anthropometrics
 The objective measurements of body muscle and fat
Biochemical/Laboratory
 Tests based on blood and urine- can be important
indicators of nutritional status
 Influenced by other nutritional factors as well
Clinical Data
 Information about the individuals medical history –
acute and chronic illness, etc.
Dietary Methods
 24 Hour recall
 Food frequency questionnaire
Assessing and Monitoring
Food and Nutrient Intake

Ensuring adequacy of the food supply

Estimating the adequacy of dietary intakes
of individuals and groups

Monitoring rends in food and nutrient
consumption

Estimating exposure to food additives and
contaminants
Measuring Diet
Most widely used indirect indicator of
nutritional status
 Estimating intake can be difficult

Weakness of data-gathering
techniques
 Human behavior
 Natural tendency of intake
 Limitations of nutrient composition
tables and databases

Methods for Measuring
Intake








24-hour recall
Food Record or Diary
Food Frequency Questionnaires
Diet History
Duplicate Food Collections
Food Accounts
Food Balance Sheets
Photographic and Digital Video Methods
Using the Internet to Assess
Dietary Intake



Many websites provide nutrition-based
information
Quality of this information ranges from
excellent to very poor
Free dietary analysis on the Internet
available since mid 1990’s

Top rated online assessment tool
• MyPyramid Tracker
• Enter food intake and receive a score on the overall
quality of diet
• Nutrient intake compared with the RDA for
nutrients and a graphic comparison with
MyPyramid
Internet Resources for Sound
Nutrition Information

Tufts University Nutrition Navigator



Mayo Health Oasis




www.pueblo.gsa.gov
Provides access to hundreds of educational materials
FDA Center for Food Safety and Applied Nutrition



www.mayohealth.org
Provides consumers with good nutrition information in a fun, user-friendly
format
Consumer Information Center


www.Navigator.tufts.edu
Provides a rating of the accuracy of nutrition content and usability of nutrition
websites
www.vm.cfsan.fda.gov/list.html
Provides government updates on food and nutrition issues and basic nutrition
guidelines
Meals for You (My Menus)


www.MealsForYou.com
Provides thousands of recipes with menu plans, shopping lists, and
nutritional analysis
Assessing Body Weight

Approaches to assessing body weight
include
Height-weight tables
 Relative weight
 Height-weight indices

Obesity Chart
ARE YOU OVERWEIGHT?
BMI Chart
BMI Chart Indicators
Risk of Associated Disease According to BMI and Waist Size
BMI
Waist less than or
equal to
Waist greater than
40 in. (men) or
35 in. (women)
40 in. (men) or
35 in. (women)
18.5 or less
Underweight
--
N/A
18.5 - 24.9
Normal
--
N/A
25.0 - 29.9
Overweight
Increased
High
30.0 - 34.9
Obese
High
Very High
35.0 - 39.9
Obese
Very High
Very High
40 or greater
Extremely Obese
Extremely High
Extremely High
Biochemical Assessment of
Nutrition Status
Use of Biochemical Measures
 Protein Status
 Iron Status
 Calcium Status
 Vitamin Status



Vitamin C. B6, Folate
Blood Chemistry Tests
Use of Biochemical
Measures

Grouped in 2 categories
Static tests
 Function tests


Biochemical tests can be used to
examine the validity of various
methods of measuring intake
Protein Status

Assessing protein status:
Anthropometric
 Biochemical
 Clinical data
 Dietary data

Protein Energy Malnutrition

PEM

Primary
• Insufficient intake of protein and calories

Secondary
• Resulting from other diseases
Kwashiorkor
 Marasmus

Iron Deficiency
Most common nutrient deficiency in
the US
 Most common cause of anemia
 Most widely used screening test



Hemoglobin
Best way to predict iron deficiency is
to use models that combine several
indicators
Assessing Calcium Status

Calcium






Essential for bone health
Tooth formation
Muscle contraction
Blood clotting
Cell membrane integrity
At the current time no appropriate
biochemical indicators for assessing
calcium status exist
Zinc
Component of numerous enzymes
 Involved in metabolic processes

Protein synthesis
 Wound healing
 Immune function
 Tissues growth and maintenance


No sensitive biochemical or functional
indicators of zinc status
Vitamin A

Assessment of Vit A Status
Static measurements of vitamin levels
in serum liver and functional tests
 Relative dose response test

• Ability to identify persons with marginal
Vitamin A status
• Limited by a 5 hour wait and need to draw
2 blood samples
Vitamin B6

Composed of 3 naturally occurring
compounds


Pyridoxine, pyridoxal, and
pyridoxamine
Factors affecting plasma PLP
concentrations
B12 Deficiency
Cobalamin
 Primary cause of deficiency



Inadequate absorption
Characterized by being in positive,
normal or negative balance
Wag More, Bark Less 
Jake April 2010
Rylee Turkey Trot
Nov 2009
Dexter July 2010
Rylee – Feb 12 2010
Freddie aka Max May 2010
My house,
Dallas , Texas
Feb 12, 2010
Freddie – Dec 2009
Rylee - January 2010
QUESTIONS?