1. NUTRITIONAL ASSESSMENT

2. SCREENING • To determine nutritional health • Look for warning signs • Maintain optimal health of healthy persons • Identify risks to medical treatment and recovery

3. SCHEMA

4. INITIAL SCREEN

5. ASSESSMENT • Identify stages in the development of deficiency disease • A = ANTHROPOMETRIC MEASUREMENTS • B = BIOCHEMICAL ANALYSIS • C = CLINICAL INFORMATION • D = DIETARY INFORMATION • E = EVALUATION/ENVIRONMENT

6. Deficiency stages

7. stages

8. ANTHROPOMETRIC MEASURE • Height • Weight • Percent of ideal body weight • Percent of usual body weight • Recent weight change – unplanned • 5% in 1 month • 10% in 6 months

9. ANTHROPOMETRIC MEASURES • Fatfolds – TSF (total subcutaneous fat) and total body fat • MAC – midarm circumference-muscle mass and subcutaneous fat • MAMC – midarm muscle mass/circumerence, skeletal muscle • BIA – lean body mass

10. BIOCHEMICAL ANALYSIS

11. CLINICAL ASSESSMENT • Look at the patient • Observe physical signs and symptoms of deficiencies and toxicities • Hair – PCM • Eyes – hyperlipidemia, vitamin deficiency • Tongue – B vitamin deficiency • Nails – protein and iron deficiency

12. DIETARY INFORMATION • Nutrition history - • Special diet order – compliance • Relate diet to disease state • Appropriateness • Meeting nutritional needs • Food/drug interactions: antibiotics, anticonvulsants, etc.

13. EVALUATION/ENVIRONMENT • Summary of findings • Recommendations • Potential problems • Socioeconomic concerns • Psychosocial concerns • Adequate housing • Disease state affects ability to prepare food • Adequate food, storage, equipment to prepare food