At the end of this Chapter you will find a link to a web page where you can test your knowledge of material in this chapter and also assignment that you are to submit after completing this chapter.
You may also begin with the questions now by clicking here othervice continue reading. To get lecture notes for this chapter click heretake this online testAnthropometric measurements
Have three main purposes a) evaluate the progress of growth in pregnant women, infants, children and adolescent b) determine under nutrition and over nutrition in all age groups c) measure changes in body composition over time These are either compared with standard norms or with previous measurements Anthropometric measurements include -height and weight -fat fold measurements and measurements of lean tissue - head circumference-in infants -to assess brain development -to determine whether infant proceeds growing normally - to determine protein kcal malnutrition and evaluate the extent of its impact on brain size - abdominal girth -to measure fluid retention or enlargement of abdominal organs Measurement of growth and development Most commonly used are height and length length-used for infants and children up to the age 3 height- for children over 3 years old. Particularly used to determine growth which depends on adequate nutrition. For adults height does not reflect nutrition status, but helps estimate desirable weight , estimate energy need, and interpret other assessment data. Once adult heigh has been achieved changes in weight may reveal either over or under nutrition. Ideally height and weight are in the same percentile . Child’s growth curve should generally stay at the same percentile throughout childhood. - below standard measurements indicate retardation sign of malnutrition. Here you want to increase the percentile to the higher one . -in obese and overweight children, the goal is to keep the weight in the same percentile while the height increases until weight becomes proportionate to the weight. - head circumference should be about the same percentile as the heigh and weight . It indicates the brain development in children under 2. Sever malnutrition in infants and before birth can severely impair brain development and number of brain cells Analysis for measures for adults The commonly used standards for nutrition assessment include 1) BMI tables 2) Metropolitan life insurance weight for heigh tables 3) Quick method for estimating desirable body weight Men= 106 + 6 for every inch over 5 feet Women 100 + 5 for every inch over 5 feet To practice the above formulas click here The assessor can generate A) Percentage Ideal body Weight %IBW %IBW = actual BW Useful in cases where individual has weighed IBW considerably more or less than average throughout life. B) Percentage usuall body weight %UBW %UBW = actual BW UBW Body fat- is measured through subcutaneous fat provide information about: -total body fat -fat-fold measures -waist to hip ratio -bioelectrical impedance Click here to view interactive tutorial on measuring body fat tutorials include - Underwater weighing - Bioelectrical impedance analysis - Dual Energy X-Ray absorptiometry - Total body electrical conductivity -all tutorials are accompanied by actual videos of procedures Mid arm muscle circumference measurement- gives information about skeletal muscle mass - provides indirect measure of the protein status of muscular organs such as the heart. Cautious Interpretation of Measures Anthropometric measurements is limited by- the skill of assessor -can be affected by hydration status of an individual -inability to detect small changes over small period of time = not valuable tool for assessing effect of illnesses on nutrition status in acute diseases Hand grip strength-Measures muscle function -reflects changes in body composition and organ function -low grip strength= weak muscle function indicates risk for poor nutrition status. . Skin test- antigen skin test measures immune function- raised hardened area after 24-48 hours appear in well nourished people For more detailed formulas used in assesment clicking here click here to practive the above formulasBiochemical analysis
They are based on analysis of blood and urine Limitation of biochemical tests State of persons hydration and fluid retention-dehydration may produce false high values -over-hydration-------// — false low values use lab values along with other assessment data Biochemical test of protein status Serum albumin- it’s the major blood protein -changes in blood serum show slowly -it takes 21 days to note any changes because albumin is abundant in the blood and breaks down slowly - low serum albumin reflects long term protein depletion Serum transferrin- protein transporting iron - its concentration reflects protein and iron status -transferring rises as iron deficiency rises and drops as iron status improves - significantly low levels of transferring indicate severe PEM - like albumin changes in blood serum show slowly= not a sensitive indicator of response to medical nutrition therapy. Total lymphocyte Count- PEM compromises immune system , reducing the number of white blood cells (lymphocytes) -it is derived from the number of white blood cells and % lymphocytes - many variables can affect the level of total lymphocytes-(infection will increase its number)-this reduces its value in nutrition therapy Urinary test of protein status a) Urinary urea nitrogen (UUN)-determines whether protein intake is adequate to meet needs. B) Urinary creatine excretion- provides indirect measure of skeletal muscle mass. Comparing creratine excretion to standarts determines whether muscle mass is adequate or depleted. - Both tests require normal kidney function for accurate results - Both require 24 hour urine collection - Not regularly performed because of the complicated process and precision with which must be collected.Nutrition screening
It is the use of routine nutrition assessment procedures to identify people who are malnourished or are at risk for malnutrition.. Screening procedures vary from facility to facility It helps to identify clients who need in depth nutrition assessment. Now test your knowledge and complete written assignment press here to begin
