1. NS 210 Unit 9 Seminar: Review for Final Project Jennifer Neily, MS, RD, CSSD, LD Kaplan University

2. Final Project

3. 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

4. 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.

5. 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

6. 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

7. Measuring Diet Most widely used indirect indicator of nutritional status Estimating intake can be difficult Weakness of data-gathering techniques Human behavior Natural tendency of intake Limitations of nutrient composition tables and databases

8. 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

9. 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

10. Internet Resources for Sound Nutrition 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

11. Assessing Body Weight Approaches to assessing body weight include Height-weight tables Relative weight Height-weight indices

12. Obesity Chart ARE YOU OVERWEIGHT?

13. BMI Chart

14. BMI Chart Indicators Risk of Associated Disease According to BMI and Waist Size BMI Waist less than or equal to 40 in. (men) or 35 in. (women) Waist greater than 40 in. (men) or 35 in. (women) 18.5 or lessUnderweight--N/A 18.5 - 24.9Normal--N/A 25.0 - 29.9OverweightIncreasedHigh 30.0 - 34.9ObeseHighVery High 35.0 - 39.9ObeseVery High 40 or greaterExtremely ObeseExtremely High

15. Biochemical Assessment of Nutrition Status Use of Biochemical Measures Protein Status Iron Status Calcium Status Vitamin Status Vitamin C. B6, Folate Blood Chemistry Tests

16. Use of Biochemical Measures Grouped in 2 categories Static tests Function tests Biochemical tests can be used to examine the validity of various methods of measuring intake

17. Protein Status Assessing protein status: Anthropometric Biochemical Clinical data Dietary data

18. Protein Energy Malnutrition PEM Primary Insufficient intake of protein and calories Secondary Resulting from other diseases Kwashiorkor Marasmus

19. 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

20. 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

21. Zinc Component of numerous enzymes Involved in metabolic processes Protein synthesis Wound healing Immune function Tissues growth and maintenance No sensitive biochemical or functional indicators of zinc status

22. Vitamin A Assessment of Vit A Status Static measurements of vitamin levels in serum liver and functional tests Relative 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

23. Vitamin B6 Composed of 3 naturally occurring compounds Pyridoxine, pyridoxal, and pyridoxamine Factors affecting plasma PLP concentrations

24. B12 Deficiency Cobalamin Primary cause of deficiency Inadequate absorption Characterized by being in positive, normal or negative balance

25. 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

26. QUESTIONS?