NS 210 Unit 9 Seminar: Review for

Final Project

Jennifer Neily, MS, RD, CSSD, LD

Kaplan University

Final Project

Behavioral Risk Factor Surveillance System (BRFSS)

State based system of health surveys that collect information on health risk behaviors, preventive health practices and health care access primarily relate to chronic disease and injury

Use the CDC website to gather information/statistics in your area

Nutritional Screening

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 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

Assessing and Monitoring Food and Nutrient Intake Ensuring adequacy of the food supply

Estimating the adequacy of dietary intakes of individuals and groups

Monitoring rends in food and nutrient consumption

Estimating exposure to food additives and contaminants

Measuring Diet

Most widely used indirect indicator of nutritional status

Estimating intake can be difficultWeakness of data-gathering

techniquesHuman behaviorNatural tendency of intakeLimitations of nutrient composition

tables and databases

Methods for Measuring Intake

24-hour recall Food Record or Diary Food Frequency Questionnaires Diet History Duplicate Food Collections Food Accounts Food Balance Sheets Photographic and Digital Video Methods

Using the Internet to Assess Dietary Intake

Many websites provide nutrition-based information

Quality of this information ranges from excellent to very poor

Free dietary analysis on the Internet available since mid 1990’s Top rated online assessment tool

• MyPyramid Tracker• Enter food intake and receive a score on the overall

quality of diet• Nutrient intake compared with the RDA for

nutrients and a graphic comparison with MyPyramid

Internet Resources for SoundNutrition Information Tufts University Nutrition Navigator

www.Navigator.tufts.edu Provides a rating of the accuracy of nutrition content and usability of nutrition

websites Mayo Health Oasis

www.mayohealth.org Provides consumers with good nutrition information in a fun, user-friendly

format Consumer Information Center

www.pueblo.gsa.gov Provides access to hundreds of educational materials

FDA Center for Food Safety and Applied Nutrition www.vm.cfsan.fda.gov/list.html Provides government updates on food and nutrition issues and basic

nutrition guidelines Meals for You (My Menus)

www.MealsForYou.com Provides thousands of recipes with menu plans, shopping lists, and

nutritional analysis

Assessing Body Weight

Approaches to assessing body weight includeHeight-weight tablesRelative weightHeight-weight indices

Obesity ChartARE YOU OVERWEIGHT?

BMI Chart

BMI Chart IndicatorsRisk of Associated Disease According to BMI and Waist Size

BMI

  Waist less than or equal to

40 in. (men) or35 in. (women)

Waist greater than40 in. (men) or

35 in. (women)

18.5 or less Underweight -- N/A

18.5 - 24.9 Normal -- N/A

25.0 - 29.9 Overweight Increased High

30.0 - 34.9 Obese High Very High

35.0 - 39.9 Obese Very High Very High

40 or greater Extremely Obese Extremely High Extremely High

Biochemical Assessment of Nutrition Status

Use of Biochemical Measures Protein Status Iron Status Calcium Status Vitamin Status

Vitamin C. B6, Folate Blood Chemistry Tests

Use of Biochemical Measures

Grouped in 2 categoriesStatic testsFunction tests

Biochemical tests can be used to examine the validity of various methods of measuring intake

Protein Status

Assessing protein status:AnthropometricBiochemical Clinical dataDietary data

Protein Energy Malnutrition

PEMPrimary

• Insufficient intake of protein and calories

Secondary• Resulting from other diseases

Kwashiorkor Marasmus

Iron Deficiency

Most common nutrient deficiency in the US

Most common cause of anemia Most widely used screening test

Hemoglobin Best way to predict iron deficiency is

to use models that combine several indicators

Assessing Calcium Status

Calcium Essential for bone health Tooth formation Muscle contraction Blood clotting Cell membrane integrity

At the current time no appropriate biochemical indicators for assessing calcium status exist

Zinc

Component of numerous enzymes Involved in metabolic processes

Protein synthesisWound healingImmune functionTissues growth and maintenance

No sensitive biochemical or functional indicators of zinc status

Vitamin A

Assessment of Vit A StatusStatic measurements of vitamin levels

in serum liver and functional testsRelative dose response test

• Ability to identify persons with marginal Vitamin A status

• Limited by a 5 hour wait and need to draw 2 blood samples

Vitamin B6

Composed of 3 naturally occurring compoundsPyridoxine, pyridoxal, and

pyridoxamine Factors affecting plasma PLP

concentrations

B12 Deficiency

Cobalamin Primary cause of deficiency

Inadequate absorption Characterized by being in positive,

normal or negative balance

Wag More, Bark Less

My house, Dallas , Texas Feb 12, 2010

Jake April 2010

Dexter July 2010

Rylee - January 2010

Freddie – Dec 2009

Rylee - Turkey Trot Nov 2009

Rylee – Feb 12 2010

Freddie aka Max May 2010

QUESTIONS?