Nutritional Analysis and Assessment Renee Gosselin, MS RD Nutritional Analysis and Assessment Unit 1: Introduction to Nutritional Assessment

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NS 210 Course Syllabus Review Course Description This course includes the study of methods and equipment used for nutritional analysis in health, obesity, and malnutrition. Students learn how to utilize the software-based and manual data-gathering systems to assess nutritional status.

Course Syllabus Review Continued Course Outcomes Upon successfully completing this course, you will be able to: List the equipment used to assess markers for obesity and malnutrition. Critically appraise various methodologies and equipment used for nutritional analysis. Assess the nutritional status of individuals.

Course Syllabus Review Continued Instructors Grading Criteria/Timetable Late Policy How to Label your Work Projects username-project-unit#.doc. Allen-Anatomical Terminology-Unit 3.doc. Seminars username-seminar-unit#.doc TAllen-Seminar-Unit 3.doc

Overview Review of Nutritional Assessment Methods Dietary Standards Anthropometrics Biochemical Clinical Dietary Dietary Standards

Nutritional Screening and Nutritional Assessment the process of identifying characteristics know to be associated with nutrition problems. Nutrition Assessment is the first of four steps in the Nutrition Care Process.

Nutrition Assessment Methods Anthropometrics The objective measurements of body muscle and fat Biochemical/Laboratory Tests based on blood and urine- can be important indicators of nutritional status Influenced by other nutritional factors as well Clinical Data Information about the individuals medical history – acute and chronic illness, etc. Dietary Methods 24 Hour recall Food frequency questionnaire

Healthy People 2010 Increase proportion of adults who are at a healthy weight Reduce the proportion of adults who are obese Reduce the proportion of children and adolescents who are overweight or obese Reduce growth retardation among low-income children under age 5 Increase the proportion of persons aged 2 years and older who consume at least 2 daily servings of fruit

Protein Energy Malnutrition (PEM) An excessive loss of lean body mass resulting from inadequate consumption of energy and/or protein or resulting from the increased energy and nutrient requirements of certain diseases

Nutritional Assessment and Diabetes Goals for persons with Diabetes are based on: Dietary history Nutrient intake Clinical data

Nutritional Assessment: Heart Disease and Cancer Diabetes serum lipoprotein Male sex Abdominal obesity Cigarette smoking Advancing age Overweight and obesity

Review of Unit 1: Introduction to Nutritional Assessment Nutritional assessment is central to monitoring and improving nutritional status Nutritional assessment is an attempt to evaluate the nutritional status of individuals

Dietary Standards Common standards for evaluating nutrient intake Dietary Reference Intakes Dietary Guidelines for Americans Regulations governing the nutritional labeling of food The MyPyramid Food Guidance System

History of Dietary Standards Advances in metabolism, vitamin and mineral research during the early twentieth century led to the establishment of human nutrient requirements. One of the first Standards were the Recommended Dietary Allowance (RDA’s) RDA does have limitations

DRI’s DRI’s include 4 Reference Values Estimated Average Requirement (EAR) Adequate Intake (AI) Tolerable Upper Level (UL) Recommended Dietary Allowance (RDA)

Estimated Average Requirement (EAR) Definition “The daily intake value that is estimated to meet the requirement, as defined by the specified indicator of adequacy, in half to he apparently healthy individuals in a life stage or gender group The EAR is defined as the daily intake value that is estimated to meet the requirement, as defined by the specified indicator of adequacy in half o the apparently healthy individuals in a life stage or gender group. The EAR serves as the basis for setting the Recommended Dietary Allowance (RDA). If an EAR cannot be established, then an RDA cannot be set. These are shown on page 19, table 2.2 Because of individual biological variation in nutrient absorption and metabolism, some individuals have a relatively low (lower than average) requirement for a nutrient, while others have a relatively high (higher than average) requirement. ERA’s are sometimes, of necessity, based on scanty data or data drawn from studies with design limitations. The criteria used in setting the EAR include the amount needed to prevent classic deficiency disease, amounts of the nutrient or its metabolites measures in various tissues during depletion-repletion studies or during induced deficiency states in health adult volunteers and the amount needed to adequately maintain a certain metabolic pathway that is dependent on the nutrient in question.

Adequate Intake (AI) A value based on experimentally derived intake levels or approximations of observed mean nutrient intakes by a group (or groups) of healthy people Observational standards - observed or experimentally derived approximations of average nutrient intake that appear to maintain a defined nutritional state or criterion of adequacy in a group of people

Tolerable Upper Intake Level (UL) “The highest level of daily nutrient intake that is likely to pose no risk of adverse health effects in almost all individuals in the specified life stage group.”

Recommended Dietary Allowance The average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97% to 98%) healthy individuals in a particular life state gender group.

Uses Of DRI’s (Daily Reference Intake) For an Individual EAR: Use to examine the probability that usual intake is inadequate RDA: Usual intake at or above this level has a low probability of inadequacy AI: Usual intake at or above his level has a low probability of inadequacy UL: Usual intake above this level may place an individual at risk of adverse effects from excessive nutrient intake For a Group EAR: Use to estimate the prevalence of inadequate intakes within a group RDA: Do not use to assess intakes of groups AI: Mean usual intake oat or above this level implies a low prevalence of inadequate intakes UL: Use to estimate the percentage of the population at potential risk of adverse effects from excessive nutrient intake

Indices of Diet Quality Diet Quality Index (DQI) Used to assess the overall diet quality of groups and to evaluate risk for chronic disease related to dietary patterns The DQI scores diet on the basis of 10 indicators of diet quality Health Eating Index (HEI) Developed by the United States Department of Agriculture (USDA) Single summary measure of overall diet quality defined in terms of adequacy, moderation and variety

Dietary Guidelines Dietary Guidelines Goals or standards primarily intended to address the more common and pressing nutrition-related health problems of chronic disease Maintenance of healthy body weight, decrease consumption of fat, increased consumption of complex carbohydrates and use of alcoholic beverage in moderation, if at all.

Nutrition Labeling Nutrition Labeling began in 1963 Nutrition Labeling and Education Act passed in 1990 RDI’s and DRV’s are collectively referred to as the Daily Values

Food Guides Nutrition education tools Foods are classified into groups according to their similarity in nutrient content Example Food Guide Pyramid

Food Exchange System Simplifies meal planning for those with limited energy consumption Helps to ensure adequate nutrient intake Originally developed for those with diabetes

Due This Week Introduce Yourself Weekly Discussion Board Unit 1 Quiz