Nutritional Assessment

Protein-calorie malnutrition (PCM)

Inadequate consumption of protein and energy, resulting in a gradual body wasting and increased susceptibility to infection.

Anthropometry

Measurement of the human body e.g. height, weight, circumferences, skinfold thickness

Kwashiorkor

Primarily a protein deficiency characterized by edema, growth failure, and muscle wasting. Babies with kwashiorkor or often getting enough calories to just get by, but they are not getting enough protein. they look bloated and fat even as they are starving. Another telltale sign is reddish hair due to protein deficiency. Not uncommon in communities where there is starvation. The mothers run out of milk and mix flour and water to feed their babies.

Serum proteins

Proteins present in serum are indicators of the body's visceral protein status (e.g., albumin, prealbumin, transferrin). Since prealbumin and transferrin have short half lives, these values show decreases earlier in starvation. Immunoglobulins are also serum proteins (and are calculated in the serum "total protein" ), but are less associated with nutritional problems for a variety of reasons.

Waist - to - hip ration (WHR)

Waist circumference divided by hip circumference as the method for assessing fat distribution (android vs gynoid distribution, apple vs pear shape). waist circumference is the smallest diameter between the umbilicus and the rib cage. The hip circumference is the largest circumference around the buttocks a WHR of 1.0 or greater in men and 0.8 in women is considered android obesity

Waist circumference

can be used alone in predicting health risks women with waist circumference >35 inches men with waist circumference >40

Nitrogen balance

condition in which nitrogen losses from the body are equal to nitrogen intake; the expected state of the healthy adult. A negative nitrogen balance would be consistent with protein deficiency and would lead to all the problems associated with protein deficiency - infection, impaired healing. is this the reason they give protein shakes to nursing home patients??

Recommended daily allowance (RDA)

levels of intake of essential nutrients considered to be adequate to meet the nutritional needs of practically all healthy persons

Malnutrition

may mean any nutrition disorder but usually refers to long term nutritional inadequacies or excesses

Marasmus

results form energy and protein deficiency, presenting with significant loss of body weight, skeletal muscle, and adipose tissue mass but with serum protein concentrations relatively intact. These babies are getting a little protein and a few energy calories and instead of looking bloated due to the edema, they look like skeletons.

Defining metabolic syndrome according to ATP III

waist >40 inches in men >35 inches in women serum triglycerides 150 or > HDL 40 or < in men, 50 or < in women BP 130/85 or higher FBG >110

Body mass index

weight in kilograms divided by height in meters squared (weight in kg's / height in meters ^2) Alternatively, (weight in pounds/height in inches) x 703. A value of 30 or more is indicative of obesity. A value of over 40 indicates extreme obesity. A value of less than 18.5 is indicative of under nutrition. This is a very useful value because you can compare from person to person. You can also track a person's weight loss and fitness using this number.

Diet History

A detailed record of dietary intake obtainable from 24-hour recalls, food frequency questionnaires, food diaries and similar methods. each of these methods have advantages and disadvantages.

Anergy

A less-than-expected or absent immune reaction in response to the injection of antigens within the skin. Describes why people who are chronically ill or malnourished may have false negative results on skin tests such as the PPD to detect TB infection

Skinfold thickness

Double fold of skin and underlying subcutaneous tissue that is measured with skinfold calipers at various body sites. The values are then read against charts to determine body fat composition. With the advent of cheap, electroimpedance devices that measure % body fat, no one does this anymore.

Android obesity

Excess body fat that is placed predominantly within abdomen and upper body which leads to "apple shape" leads to higher waist to hip ratio. Associated with greater morbidity with conditions such as cardiovascular disease and diabetes. think "Rosanne Barr."

Gynoid obesity

Excess body fat that is placed predominantly within the hips and thighs which leads to "pear shape" not by any means healthy, but less dangerous than android obesity. Think "Jennifer Lopez"

Obesity

Excessive accumulation of body fat. Commonly defined as 20% above desirable weight or BMI >30. Body fat percentages vary with sex and age. More than mid-30%s for women and low to mid 20s for men is considered high