Nutritional Assessment

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Nutritional Assessment

• A.B.C.D.

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• Nutritional Assessment
• 1. A anthropometric
• 2. B biochemical
• 3. C clinical
• 4. D dietary

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A

• Anthropometric
• Weight
• Height
• Lean body mass
• Blood pressure
• Aerobic competency
• Psychological stress adaptability

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B

• Biochemical
• Laboratory values
• Mineral analysis
• Tissue analysis

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C

• Clinical
• Physical examination findings

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D

• Dietary Analysis
• Review foods eaten
• Review preparation methods
• Evaluate digestive and absorption adequacy
• Review supplements taken
• Review medications taken

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Clinical Manifestations

• Protein Status
• Edema is a major factor in protein deficiency
• Mineral deficiency (protein is carrier)
• Immunological challenges (protein for immune
  functions
• Tissue changes, i.e. nails, hair, muscles, etc.

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Protein Excess

• Tremendously taxing to liver and kidneys
• Kidney failure can eventually result

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Carbohydrate Status

• Hypoglycemia
• Hyperglycemia

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Lipid Status

• More prevalent due to many fat-free products.
• May result in deficiencies of essential fatty
  acids
• The chemicals may reach toxic levels

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Appearance of Patient

• Observe facies
• Moon face Pagets
• Emaciated Acromegaly
• Facial Edema Myxedema
• Ocular Symptoms Skin Color,
• Butterfly rash Texture,
• Mask-like facies Moisture

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Hair

• If healthy will be shiny and appropriate color
  for age
• (This can be unreliable due to many artificial
  things people do to the hair)

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Nails

• Nail conditions
• Spoon nails
• Club nails
• Koilonychia
• White spots
• Longitudinal ridges

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Nail Conditions (continued)

• Beaus Lines
• Splinter hemorrhages
• Pitting

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Laboratory Values

• Interpret similarly to clinical knowledge
• Vitamin levels not economically feasible.
• Some minerals may be useful, for example
  magnesium. Calcium IS NOT relevant.

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Hair Analysis

• May be overrated
• Often useful for toxic levels
• Useful if carefully interpreted and not over
  interpreted

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Muscle Testing

• No scientific data
• Results not reproducible
• Better methods exist so why spend time on
  unproven tools?

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Observation of Patient

• Perform complete and comprehensive evaluation of
  patient including posture, gait, muscular
  condition, voluntary and involuntary movements,
  etc.

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Iridology

• Another unproven method of determining
  nutritional status.
• Suggest that already proven methods may be best
  and will result in the same outcomes obtained
  from using unproven methods.

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Patient History

• Perform comprehensive patient history
• Delve
• Find out how they eat
• Find out about lifestyle
• Find out their health status as they perceive it

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Patient History (continued)

• Determine patients goals for their health
• Ask about number of hours of sleep, naps,
  fatigue, etc.
• Ask about degree of satisfaction with their life
  situation and work as it applies

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Nutritional Companies

• Many will produce food questionnaires. Patient
  completes it and the company analyzes the results
  by computer and mails you a comprehensive report
  about patients nutritional status.
• Take care as some are designed to push products

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Remember Main Goal

• Is the patient receiving, either from natural
  foods, or from quality supplements, the necessary
  nutrients to be as healthy as possible?