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

2. 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!

3. Tell me something about yourself!

4. 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.

5. 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.

6. 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
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TAllen-Seminar-Unit 3.doc

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

8. 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.

9. 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

10. 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

11. 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

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

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

14. 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

15. 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

16. 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

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

18. 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.

19. 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

20. 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.”

21. 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.

22. 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

23. 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

24. 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.

25. 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

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

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

28. Due This Week
Introduce Yourself
Weekly Discussion Board
Unit 1 Quiz