Nutritional Analysis and Nutritional Analysis and AssessmentAssessment

Unit 1: Introduction to Nutritional Assessment

Renee Gosselin, MS RD

How is everyone?

My name is Renee Gosselin, MS RD

I have experience in clinical, long-term care, acute care, research, educational and community nutrition!

Tell me something about yourself!

NS 210 Course Syllabus NS 210 Course Syllabus ReviewReview

Course DescriptionThis 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 Course Syllabus Review ContinuedContinued

Course OutcomesUpon 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 Course Syllabus Review ContinuedContinued

Instructors Grading Criteria/TimetableLate PolicyHow to Label your Work

Projectsusername-project-unit#.doc. Allen-Anatomical Terminology-Unit 3.doc.

Seminarsusername-seminar-unit#.doc TAllen-Seminar-Unit 3.doc

OverviewOverview

Review of Nutritional Assessment MethodsAnthropometricsBiochemicalClinicalDietary

Dietary Standards

Nutritional Screening and Nutritional Screening and Nutritional AssessmentNutritional Assessment

Nutritional Screening 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 MethodsNutrition 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 2010Healthy People 2010

1. Increase proportion of adults who are at a healthy weight

2. Reduce the proportion of adults who are obese3. Reduce the proportion of children and adolescents

who are overweight or obese4. Reduce growth retardation among low-income

children under age 55. Increase the proportion of persons aged 2 years

and older who consume at least 2 daily servings of fruit

Protein Energy Malnutrition Protein Energy Malnutrition (PEM)(PEM)

PEMAn 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 Nutritional Assessment and DiabetesDiabetes

Goals for persons with Diabetes are based on:Dietary historyNutrient intakeClinical data

Nutritional Assessment: Nutritional Assessment: Heart Disease and CancerHeart Disease and Cancer

Diabetesserum lipoproteinMale sexAbdominal obesityCigarette smokingAdvancing ageOverweight and obesity

Heart Disease

Review of Unit 1: Introduction Review of Unit 1: Introduction to Nutritional Assessmentto 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 StandardsDietary Standards

Common standards for evaluating nutrient intakeDietary Reference IntakesDietary Guidelines for AmericansRegulations governing the nutritional

labeling of foodThe MyPyramid Food Guidance System

History of Dietary Standards 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’sDRI’s

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

Estimated Average Estimated Average Requirement (EAR)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

Adequate Intake (AI)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 Tolerable Upper Intake Level (UL)(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 Recommended Dietary AllowanceAllowance

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 Uses Of DRI’s (Daily Reference Intake)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 QualityIndices 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 GuidelinesDietary Guidelines

Dietary GuidelinesGoals 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 LabelingNutrition 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 GuidesFood Guides

Nutrition education tools

Foods are classified into groups according to their similarity in nutrient content

ExampleFood Guide Pyramid

Food Exchange SystemFood 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