Assessment of Nutritional status Dr Paul T Francis, MD Prof. Com Med 7th April University, Zawia, Libya

Contents Need for nutritional assessment Types of surveys Elements of nutritional assessment Clinical examination Anthropometry Lab and Biochemical tests Dietary survey Study of vital statistics Assessment of ecological factors

Aim of nutritional assessment To identify nutritional problems of the community To find the underlying cause for malnutrition To plan and implement(نجز) control of malnutrition Maintain good nutrition of community

Types of surveys Longitudinal Cross-sectional In longitudinal surveys some families are observed (راعى, لاحظْ) for one year or longer In cross-sectional survey a sample is examined for prevalence of malnutrition

Elements of Nutritional Assessment Clinical examination Anthropometry Laboratory and biochemical tests Dietary surveys Study of vital statistics Assessment of ecological factors

Clinical examination Person is examined for signs of malnutrition e.g.. Anemia, rickets.

Anthropometry Weight (for age) Height (Length in children <2years Is the most important measure for assessing malnutrition Height (Length in children <2years Head circumference in 0-4 years Mid-upper arm circumference Skin fold thickness

Weight (for age) Weight of the child can be plotted on a growth chart to monitor the growth of the child The upper and lower limit of normal weight is shown by two lines – road to health The weight of the child should be between the two lines If the weight of the child is below the lower line it is malnutrition and if the weight of the child is above the upper line it is overweight

Growth chart ‘Road to Health chart’

Laboratory and Biochemical examination Laboratory tests – Hb, stool for ova Biochemical tests – Serum protein, serum iron etc. Biochemical tests are usually done on a small sample of people

Dietary surveys Dietary survey provide a real picture of the food consumption of the community It can be done in three ways: Weighing of raw foods for about 7 days and a average daily consumption is calculated Weighing cooked food. Even though this is better, most people do not like it. Oral questionnaire method – quantity of food eaten over the last 24 hours is calculated.

The study of Vital Statistics Nutritional status influence these rates Infant Mortality Rate Rate of Low Birth weight Life expectancy

Assessment of Ecological factors Is necessary to get the complete picture of nutritional status. They are: Cultural factors - food habits, beliefs Food production – food cultivation, storage, marketing Socio-economic factors – family size, educational status, per-capita income Health and nutritional services – immunization, feeding programmes

Summary It is important to assess the nutritional status of the community to promote health, prevent malnutrition and control malnutrition. Nutritional surveys will give us the information Methods of nutritional assessment are: Clinical examination

Summary cont’d Anthropometry Lab and biochemical test Dietary survey Study of vital statistics Assessment of ecological factors Good nutrition leads to healthy people and health community