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Nutrition Chapter 13 Lecture 2 (Dietary Assessment Methods (Food record-…
Nutrition Chapter 13 Lecture 2
Historical Information
There are different types of historical information obtained in a nutritional assessment:
Medical History
Age
Current complaints
Past medical conditions
Family medical hx
Chronic disease risk
Allergies
Mental /emotional abuse
Medication & supplement history
Prescription drugs
Over-the-counter drugs
Dietary & herbal supplements
Personal and Social Hx
Employment status
Educational level
Socioeconomic status
Cultural/ethnic identity
Religious beliefs
Home/family situation
Cognitive abilities
Use of tobacco/drugs (illegal)
Food and Nutrition Intake history
Food intake
Dietary restrictions
Physical activity & exercise habits
Alcohol consumption
Food allergies & intolerances
Nutrition & health knowledge
Food availability
Dietary Assessment Methods
Obtaining an accurate food intake data is challenging and result can vary depending on pts. Memory and honesty
Several methods can be used
24-hour recall- guided interview where person recounts all of the foods and beverages consumed in 24 hour period
All foods & beverages
Time of day eaten
Amounts consumed
Food preparation
Typical day?
Food intakes underestimated because the process relies on a persons memory and reporting accuracy.
People forget to mention ETOH, soft drinks, snack foods, and desserts
Food frequency questionnaire-surveys the foods and beverages regular consumed during a specific time period.
Some questionnaires are qualitative- food lists contain common foods, organized by food groups
Others provide semi quantitative information that includes portion sizes
Asked to estimate food intakes over a one year period, the results should not be affected by seasonal diets.
A disadvantage is the inability to determine recent changes in food intake
Food record- is written account of foods and beverages consumes during a specific time period
Recorded over several days
Recorded as consumed
Does not rely on memory
Includes types and amts of food, and beverages, time and methods of preparation
Great deal of time to complete and people need to be highly motivated
Recording process may influence food intake
Direct observation is when a facility serves meals, food intake can be directly observed and analyzed
Can reveal food preferences , changes in appetite and any problems with a prescribed diet
Kcalorie counting
Time consuming
Anthropometric Data
Anthropometric data is related to physical measurements of the human body
This can be reveal problems with over nutrition and PEM(protein energy malnutrition)
Common to use to evaluate growth in children and nutrition status in adults
Height: Adults & older children
Length
Infants
< 24 months
Any child or adult that can not stand due to physical or medical conditions
Weight
Body Mass Index (BMI)
Healthy between 18-24.5
Reminder BMI= weight in kg/height in meters squared
Head circumference
Assesses brain development up to 3 years of age
Measurement is read to the nearest 1/8th of an inch
Circumference of waist & limbs
Evaluates body fat
Evaluates muscle mass
Waist circumference correlates with intra-abdominal fat
Often used together with skin folds measurements
Biochemical Analysis
Provides information about
Protein-energy nutrition
Vitamin & mineral status
Fluid & electrolyte balance
Organ functioning
Completed with analysis of blood & urine samples
Repeated measures are more helpful than a single value this way it can be determined if a condition is improving or worsening
Challenge is factors can influence a test result
Protein can be affected by fluid imbalances, pregnancy, infections
A variety of tests are generally needed for a dx of a nutritional problems
Plasma Proteins
Albumin
Most abundant
Slow to reflect changes in status
Transferrin
Transports iron
Indicates PEM & iron status
Slow to detect changes in status
Prealbumin & retinol-binding protein
Also called transthyretin
Responds quickly to changes in protein status
Expensive test
Fluid Imbalance
May accompany some illnesses and can result from certain medications . It is important to be aware of the physical signs of fluid retention and dehydration
Edema
Weight gain
Facial puffiness
Swelling limbs
Abdominal distention
Tight-fitting shoes
Causes
Diseases of heart, kidney, liver, lungs
Dehydration
Thirst
Dry skin or mouth
Reduced skin tension
Dark yellow or amber urine with low volume
Causes
Fever, sweating, vomiting, diarrhea, burns