Nutrition Assessment: Ch 7 Review Questions
Part of the body composition know as body fat mass or tissue, including two predominant compartments, visceral and subcutaneous fat.
Adiposity
Height-measurement accuracy is important and should be measured with an accurate stadiometer with a fixed vertical ruler and an adjustable sliding horizontal headpiece. The person being measured, while standing on a hard floor, is requested to stand up straight, look forward with relaxed arms at the sides, straight legs close together, and feet flat with the heel together. The head is positioned by the technician, taking the measurement in the Frankfort horizontal plane in which the lower eye lid or socket is horizontally level with the top of the ear. If a person is unable to stand or is bedridden, then using demispan, knee height (KH), or ulna length (UL) (FIGURES 7.4, 7.5,and 7.6) for estimating a person's height are options.
Adult stature
Height is influenced by a variety of factors, including racial and ethnic differences, because both of these can affect the actual height measure and interpretation as well as the relationship between them. As people age, height decreases, beginning sometime between ages 30 and 50, and varies by gender, with women's height decreasing more rapidly with age. Factors affecting height measurements include postural changes, decrease in vertebrae height, and conditions limiting the ability to stand straight(such as kyphoscoliosis or disease-related curvature of the spine and arthritis). All of these can limit accurate height assessment and result in poor interpretation of BMI and its associated health risks.
Advantages and Limitations of adult stature
Apple-shaped body type in which is primarily in the upper part of the body, such as the abdomen; more common in males and associated w/ increased health risk.
Android
Measurements taken of various parts of he human body; used for population comparisons for determining body composition and nutritional status.
Anthropometry
Measure of body fat that is the ratio of the weight of the body in kilograms to the square of its height in meters.
BMI
Single-frequency of multifrequency system for measuring body composition using measurements of resistance and reactance or the impedance of electrical conductivity of the body to determine total body water, body fat percentage, and fat-free mass.
Bioelectric impedance analysis
_______ _______ _______ is another method used to determine BC. This method uses measurements of resistance and reactance or impedance of electrical conductivity of the body. In theory, electrical current passes through the low-resistance electrolyte- containing water portion of the body.
Bioelectrical Impedance Analysis (BIA)
Way to assess body composition that evaluates the cellular functions of the components of the body (muscle, viscera, blood, and brain).
Body cell mass
Distribution of protein, fat, water, and minerals that make up the human body.
Body composition
Models for determining BC focus on the components measured. The two components model evaluates only body fat mass and FFM, the three components model adds bone, and the four components model adds bone and total body water (FIGURE 7.14). Methods also vary in complexity for what is measured from the whole body (BMI, weight, anthropometry), molecular, cellular, and tissue (blood, bone, adipose tissue, skeletal muscle), or body cell mass (BCM).
Body-Composition Measurements and Models and Techniques
A complex metabolic syndrome associated w/underlying illness and characterized by loss of muscle w/ or w/o loss of fat mass.
Cachexia
For pragmatic purposes, National Institute of Aging recommends the _______ _______ anthropometric measurement to assess muscle mass and bone density.
Calf Circumference (CC). (Similar to the MUAC, calf and thigh circumferences can be measured to assess muscle mass. The loss of skeletal muscle and its associated effects on physiological & functional decline occurring with aging has led to the need for quick and accurate noninvasive methods predicting functional capacity, balance issues or risks for falls, and bone mineral density (BMD)).
Scanning method involving an x-ray tube and a receiver to produce an image that is used as a diagnostic test to detect the presence of tumors, vascular diseases, pulmonary emboli, or aortic aneurysms.
Computerized tomography
Anthropometric indicator below which either individuals or populations will require an intervention or therapy.
Cutoff point
Method for evaluation body volume and density to estimate percentage of body fat and fat-free mass such as underwater weighing and air displacement plethysmography.
Densitometry
Three-compartment method using low dose x-rays to assess body composition, both regional and whole body, in adults and children.
Dual-energy x-ray absorptiometry (DEXA)
Tool used to assess grip strength by measuring static force in kilograms or pounds; can be measured by isokinetic, electrical, digital, or electronic means.
Dynamometer
Adipose tissue that surrounds and protects organs, bones, and the nervous system; needed to maintain health.
Essential fat
Part of the body composition representing lean body tissue.
Fat-free mass
- Body measurements are essential in the analysis of the development or progression of disease and for monitoring the efficacy of treatment. - Accurate measurement of changes in BC because of interventions is vital in planning nutritional care and the management of developmental and aging processes, disease progression, and rehabilitation efforts. - In pediatrics, the essential, static measurements for infants up to age 2 years are length, weight, head circumference (HC), and weight for length. For ages 3 years and older, they are height, weight, and BMI.
Foundations in Pediatrics & Children
Model used for evaluation body composition; includes body fat mass, fat-free mass, bone, and total body water.
Four-components model
Pear-shaped body type characterized by smaller fat cells in the hips and thighs
Gynoid
Quick quantitative index for assessing upper-body strength and a good predictor of health changes, morbidity, and mortality for adults and children.
Handgrip strength
Measured until age three to assess brain development
Head circumference or Frontal-occipital circumference
Measurement for detecting growth abnormalities early in the course of all types of chronic illness.
Height velocity
Magnetic resonance imaging and computed tomography are two _______ techniques that provide the most precise and specific tissue-level analyses, including measures of total adipose tissue, subcutaneous adipose tissue, visceral adipose tissue, and intestinal adipose tissue. - MRI is a noninvasive method that uses strong magnets and radio waves to construct an image; it can provide high-resolution images of vessels as small as 2 mm in diameter, which enables the detection of an occlusion or tumors in difficult-to access areas. - CT is a radiographic technique, with or without intravascular injection of a contrast material, to display a cross-sectional image of targeted areas.
Imaging
Deformity of the spine characterized by abnormal curvature of the vertebral column in the coronal and sagittal planes.
Kyphoscoliosis. Term is a combination of kyphosis and scoliosis.
Closed system using strong magnetic field to obtain a view of the chemical composition of body tissue and visual images of organs, structures, and tissues.
Magnetic resonance imaging
The ________ ________ _______ _______ is measured at the same location used for the triceps skinfold. The measurement is taken with the elbow extended and the arm relaxed to the side of the body, with the palm facing the thigh.
Mid-Upper-Arm Circumference (MUAC) (Circumference measurements can be used alone or in combination with skinfold measurements or other circumferences to help evaluate nutritional status. The only tool required to measure arm circumference is a flexible tape measure in either metric or imperial measure. (If imperial measure is used, it will need to be converted to metric))
An indicator of muscle mass. Estimating _______ _______ _______ _______ is an evaluation of overall muscle mass and is based on the following assumptions: (1) Arm muscle and bone are circular, and (2) the TSF measurement is twice the thickness of fat and bone.
Mid-Upper-Arm Muscle Area (MAMA)
Position of an individual on a given reference distribution comprising 100 points.
Percentile
For clinical practice and ongoing assessment, _______ _______ _______ are more applicable for measuring abdominal obesity. There are four sites identified for measuring: (1) the narrowest point between the thorax and waist, (2) the midway or slimmest point between the last rib and the iliac crest, (3) the highest point or just above the iliac crest, and (4) the umbilical level.
Sagittal Abdominal Diameter (In comparison to SAD, WC is a less reliable measure because the measurement can be influenced by anatomical site used, age, and weight. SAD is measured using a standardized sliding beam abdominal caliper with the subject in the supine position, knees bent)
A condition characterized by loss of skeletal muscle mass and function.
Sarcopenia
Early technique of measuring subcutaneous fat by specially designed calipers.
Skinfold thickness
Approximately 10% of total body fat; found between muscles and subcutaneous tissue.
Subcutaneous adipose tissue.
Index for assessing risk or documented osteoporosis; calculated based on bone density of a healthy 30-year-old person to determine bone mineral density and strength.
T-score
Like CC, _______ ________ is an alternative marker of muscle mass and a predictor of risk for bone fracture because of its linear correlation with BMD and hip strength.
Thigh Circumference (TC). (Similar to the MUAC, calf and thigh circumferences can be measured to assess muscle mass. The loss of skeletal muscle and its associated effects on physiological & functional decline occurring with aging has led to the need for quick and accurate noninvasive methods predicting functional capacity, balance issues or risks for falls, and bone mineral density (BMD)).
Model used to evaluate body composition; includes body fat mass, fat-free mass, and bone.
Three-components model
Component or method used to assess nutritional status and body composition.
Total body potassium
Sum of extracellular and intracellular water that correlates w/fat-free mass as compared to intracellular water.
Total body water: Hydration Status
Model for evaluating only body fat mass and the body's fat-free mass
Two-components model
Scanning method for isolating and distinguishing body fat and lean tissue based on reflected ultrasound waves and differences in the acoustic impendence between tissues.
Ultrasound
Hormonally active component of total body fat that possesses unique biochemical characteristics that influence several normal and pathological processes in the human body.
Visceral adipose tissue
Computerized screening tool that incorporates T-score along w/risk factors (smoking, family history, and lifestyle) to estimate a person's risk for such bone diseases as osteoporosis.
WHO fracture-risk assessment tool
_______ _______ provides an independent risk predictor beyond BMI measurements.
Waist circumference (Waist circumference is particularly meaningful in individuals who are categorized as normal or overweight by BMI standards. At BMIs equal to or more than 35, waist circumference has little additional predictive power of disease risk beyond that of BMI, so it is not necessary to measure waist circumference in individuals with BMIs 35 and above. The waist circumference at which there is high risk of disease, including cardiovascular disease, type 2 diabetes, dyslipidemia, and hypertension, are as follows: men > 102 cm (> 40 inches) and women > 88 cm (> 35 inches)).
_______ _______ _______ _______ was developed as an indicator of central obesity and for risk of CVD. In theory, this measurement takes into consideration a person's size by dividing the WC by height. Studies have shown that this measure has the ability to identify adverse cardiometabolic risk profiles not only in those with normal weight but also in those with normal metabolic risk profiles in the overweight or obese classifications.
Waist-to-Height Ratio (WHtR) (WHtR has the potential to identify metabolic abnormalities and risk. WHtR has been studied as a simple anthropometric index in the detection of central obesity and in the assessment of associations between cardiometabolic risk factors and central intra-abdominal obesity. There are concerns that this index does not adjust for age, particularly during periods of growth, or for gender).
More details on Pg 230
Weight and Stature for Adults
The measurement is recorded to the nearest 0.1 kg. The ratio of weight-to-length is used to predict adiposity in children under 2 years of age, rather than BMI. This measurement should also be plotted on a standardized growth chart.
Weight and Stature for Children. (Weight and stature are key for assessing growth patterns and determining deviations from the norms for a specified population. Abnormal growth patterns can signify changes in nutritional status, either because of nutrient malabsorption caused by a disease such as cystic fibrosis and inflammatory bowel or by poor nutritional intake. Malnutrition has variable effects, but clinically these can be noted in changes in anthropometric measures, including height, weight, and changes in lean body mass and adipose tissue).
Ratio measure used in calculating body mass index.
Weight to length
Standardized measures that r comparable across ages, sexes, and measures.
Z-scores
BMI, a _______ _______ _______ _______, is calculated by dividing weight in kilograms by the square of a patient's height in meters. The result indicates whether the patient is overweight, normal weight, or underweight.
weight-to-height ratio
