Nutrition Care Process - LESSON 4: NUTRITIONAL

Functional Change Physiological

ASSESSMENT

NUTRITIONAL STATUS of individuals or population Clinical symptoms Clinical

groups as influenced by their intake and utilization of
Anatomical signs Clinical
nutrients which change throughout the life cycle as it
reflects the situation at a certain time point.
Note: A state of a persons health in terms of nutrients in his or her diet ANTHROPOMETRIC MEASUREMENT
NUTRITIONAL ASSESSMENT - the interpretation of ANTHROPOMETRY
information from ABCD.
● Comes from the words “anthropos” (human) and
Note: systematic process of collecting/ interpreting information in order “metric” (measurement)
to measure the nutrition related health issues that affects the individual
● Concerned with the measurement of the body
NUTRITIONAL ASSESSMENT SYSTEM size and weight and proportion.
● NUTRITIONAL ANTHROPOMETRY -
1. NUTRITION SURVEY -;Data collected only once concerned with the measurement of the
to establish baseline nutritional data or ascertain variations of dimensions, proportion and gross
the overall nutritional status of the population. composition of the human body at different age
(chronic malnutrition) levels and degrees of nutrition
Note: a method of which the information is obtain concerning the Note: Measurements of physical dimensions; it is used because this is
nutritional status of a population; asking nutrition related questions; less expensive and invasive
evaluate the impact of changing health and socioeconomic conditions ;
● INDICATIONS:
assess the impact of intervention program and increase awareness of
nutrition problems
2. NUTRITION SURVEILLANCE - Data collected Common Body Parts Indication of
in continuous manner to identify and monitor the Measured Measurement
nutritional status of selected population or group.
Weight Body Mass
It can monitor the impact of the program (acute
and chronic) Length or Height Skeletal growth
note: a system establish to continuously monitor the dietary intake and
nutritional status of a population using a variety method of data
collection ; it is important because this is part of an evidence used to Knee Height Skeletal growth
formulate and monitor responses
3. MONITORING - high-risk individuals Skinfold Body Fat
note: need for come up healthy eating advises
4. NUTRITION SCREENING - Data collected using Mid-upper Arm Fat and fat-free mass
Circumference
simple and affordable tools that can be applied
rapidly on a large scale. Individuals are
Mid Arm Circumference Fat-free mass
compared with cutoff points.
- Used to identify malnourished individuals who Waist hip ratio Android Obesity
require interventions.
note: a first line process of identifying patients the already
malnourished or at risk of becoming INTERPRETATION OF ANTHROPOMETRIC
MEASUREMENTS
MEASUREMENT
● To interpret anthropometric measurements,
● size or a quantity measured by a standard.
anthropometric index must be constructed and
● Indices constructed from two or more raw
compared with standards or reference values.
measurements on a single subject.
● INDEX- derived directly from:
● Reference Values obtained from healthy
a. single raw measurement (in relation to
population.
age)
● Cut off Points based on the relationship between
b. combination of two requirements
indices and functional impairment.
c. simple numerical ratios
note: the gross composition of the human body; reference values is the ● REFERENCE VALUE - a device or tool for
correct measurement for each body part, used for comparison during grouping and analyzing data; it implies the
nutrition analysis; difference of reference value to cut off points is cut current average situation of apparently or
off points is design to identify at risk of percent outcomes as a result of
under or over exposure nutrients and those who are not at risk of those reasonably healthy children in the population.
outcomes ● STANDARD - It implies a target; the full potential
that a population may be able to attain given
METHODS AND STAGES optimum conditions for growth.

Stages Methods USES

Dietary Inadequacy Dietary ● Detect PEM in all age groups.

● Evaluate the progress of growth in infants,
Charge in reserve of tissue Biochemical children and adolescents, and pregnant women
store ● Monitor changes in growth and/ or body
composition overtime.
Change in level of body fluids Biochemical
ADVANTAGES
Change in functional levels Anthropometric/
● Safe and non-invasive
Biochemical
● Economically to carry out
Change in nutrient dependent Biochemical ● Relatively easy to carry out
enzymes ● Objective
● Can asses previous Nutritional History

Crystal Gail M. Tangzo _BSND 2202

DISADVANTAGES
PROCEDURES
● Limited only to PEM and cannot pinpoint A. Length
nutritional deficiencies and imbalance or ➢ Socks and shoes must be removed
excesses. ➢ The child should lie in a supine position, with head
towards the headboard and the body parallel to the
● Needed to know the precise age of the subject
backboard
for correct interpretations of measurement. ➢ Child’s buttocks and shoulder should touch the
● If done by untrained personnel, there is surface of the backboard
considerable potential for inaccuracy of ➢ Two examiners are required to correctly position
measurement. the child:
ONE: Hold the head of the child so that the head is in
WHY A DIRECT METHOD? contact with the headboard.
● It is because it is based on the actual TWO: Hold the knee to keep it straight and move
forward to the footboard to rest firmly against the
observation of the subject.
heels
● Appearing signs and symptoms can be
➢ Record measurement to the nearest .1 cm or mm
observed in the subject.
note: the direct method deals with individual or objective criteria while
B. Height
the indirect method it uses community health indices reflecting
➢ Subject should stand on the platform without shoes
● Anthropometric measurement is a direct on.
method of assessment like Biochemistry and ➢ The subject should stand straight looking straight
Clinical Assessment. ahead.
➢ Shoulder blades should be relaxed and must
COMMONLY USED MEASUREMENTS touched the measurement surface with the buttocks
and heels
I. WEIGHT ➢ Make sure that the subjects’ knees are not flexed
● The most commonly used indicator of nutritional and the heels are not lifted from the floor.
status and fluid balance. ➢ Lower the moveable headboard or bar gently until it
● An assessment of body mass firmly touches the crown of the head.
● Popular among health workers and parents because ➢ Take the measurement with the examiner's eye
of its usefulness as a source of health education. level and read it to the nearest mm
● Gives a sensitive indication of current nutritional
status COMMON INDICES OF WGT AND HGT
● Equipment: 1. Weight- for- age
- Infant Bed Pan Weighing Scale ● Common method used for interpretation of weight
- Espada data because it is easy to compute and
- Spring-Type Scale understandable to all.
- Clinical Weighing Scale ● General index of undernutrition.
● Used to assess PEM when the measurement of
PROCEDURES length or height is difficult.
A. Weighing infants:
➢ Cover the pan of the pediatric scale with a blanket 2. Height- for- Age
or towel ● It is expressed as the function of the height of a
➢ Balance scale to zero reference population of the same age.
➢ Place the infant in the middle of the pan to assure ● Index of past chronic nutritional status.
that weight is properly distributed ● Measures stunting.
➢ Once the infant is lying quietly, record the weight to
the nearest 10 grams. 3. Weight- for- height
● Sensitive index of current nutritional status
B. Weighing children and adults: ● Age - independent for the first ten years
➢ Calibrate the instrument with known weights to ● Measures wasting
determine the accuracy of the scale ● It differentiates “wasted” and “stunted” in an
➢ Scale must be placed on a hard surface and individual.
balance it to zero
➢ Weigh the subject barefoot and with light clothing INTERPRETING WEIGHT AND HEIGHT
➢ subject should stand unassisted; stand straight but MEASUREMENTS FOR ADULTS
relaxed with hands at the sides 1. Compare the actual body weight to desirable
➢ Read the measurement at eye level and record it to body weight tables. Use its ranges.
the nearest 100 g. 2. Compute DBW based on height using any of
the formulas.
II. LENGTH 3. Compare present weight with usual body
● It assesses the linear dimension which is composed weight (UBW).
of the legs, pelvis, spine and the skull. 4. Determine recent weight change.
● Being a dimensional measurement, it is less 5. Determine Body Mass Index
sensitive than weight.
● It assesses the linear growth.
● Used as an index of chronic nutritional status of
children and adults.
● It indicates stunting of a child’s full growth potential.
● Equipment:
- Microtoise
- Stadiometer
- Infantometer
● Length (Recumbent Length) used to measure
subjects who cannot stand without assistance
(obtained the subject lying down). III. CIRCUMFERENCE MEASUREMENT
● Height (Stature) used to measure older children and ● It provides the data on body composition.
adults, standing height (stature) is measured. ● Instrument used should be flexible and non-

Crystal Gail M. Tangzo _BSND 2202

stretchable. - Densitometry - underwater weighing
● The following body parts may be measured for the - Gaseous uptake of fat-soluble gases
nutritional assessment purposes: head, neck, - Radiological anthropometry
shoulder, chest, waist, abdomen, hip, thigh, calf, - Skinfold calipers:
ankle, arm, forearm and wrist. ● Triceps
● Subscapular
COMMON CIRCUMFERENCE MEASUREMENTS ● Suprailiac
Head Circumference
● Used to detect abnormalities of head and brain V. ASSESSMENT OF FAT-FREE MASS
growth particularly in the first year of life. ● It is a mixture of protein, minerals and water. The
● Can be used as an index for PEM for the first two muscles serves as the major protein source.
years of life. Assessment of the muscle provides an index of the
● PRINCIPLE: Chronic malnutrition during the first few protein reserves of the body.
months of life or during the intra- uterine growth may ● Muscle mass can be determined by measuring arm
impair brain development which can result to muscle area.
abnormally low head circumference. ● Arm muscle area cannot be measured directly but it
can be derived mathematically using MUAC and
Chest/ Head Circumference Ratio triceps skinfold measurement.
● Detects PEM in young children.
● A C/ H Ratio of less than one (<1) for children aged VI. NUTRITIONAL ASSESSMENT FOR
6 moths to 5 years is an indicative of fat and muscle NON-AMBULATORY SUBJECTS
wasting. ● It is used to approximate height and weight of a non-
● PRINCIPLE: At 6 month of age, head and chest are ambulatory patient/ subject usually used for geriatric,
about the same. After this, chest grows rapidly and and ill subjects that are bed ridden.
skull grows slowly. Therefore, a ration of <1 may be ● Kinds of Assessments:
due to wasting of the muscle and fat and can be a Knee Height
community indicator of PEM. ■ Correlated with stature; used in person with severe
Mid- Upper Arm Circumference spinal curvature and unable to stand.
● Can be used for rapid diagnosis of PEM in children ■ May also be used with Mid- arm circumference to
1-4 years of age. predict the weight of the person who cannot be
● PRINCIPLE: The arm contains subcutaneous fat weighed through conventional methods.
and muscle. A decrease in mid- upper arm ■ Measure through the use of a knee caliper.
circumference may therefore reflect either a reduction Male: (2.02 x knee height (cm))-((.o4 x age
in muscle mass reduction in subcutaneous fat, or (yr)) + 64.19
reduction in both subcutaneous fat and muscle mass Female: (1.83 x knee height (cm))-((.24 x age
(yr)) +
Waist Circumference 84.88
● Measures Obesity Calf Circumference
● Reflects intra-abdominal fats ■ Can be used to approximate weight
● Recommended Waist Circumference: ■ Can be measured by the use of non- stretchable
< 102 cm for Males tape.
< 88 for Females ■ Formulas:
Weight (W)= ((1.27 x CC) + (.87 +KH) + (.98 x
Waist- hip Ratio MUAC +.4 x
● Indicate the abdominal fat distribution SSF)) – 62.35
● Simple indicator of android obesity Weight (M)= ((.98 x CC) + (.1.16 +KH) + (1.73
● WHR: W(cm)/H(cm) x MUAC +.37
● Recommended: x SSF)) – 81.7
Male: <1 Arm length to approximate height
Female: <.85 ■ It is used to compare measurement with height
equivalent table

SUMMARY

● Standardized techniques for measuring stature

(height or length), knee height, head
circumference, body weight and elbow breadth
in infants, children, and adults are available and
should be used to ensure accurate and precise
measurements.
● Weight for Age assess acute PEM but tends to
overestimate malnutrition in children who are
either genetically short or stunted because it
does not take height differences into account
● Weight for height differentiates between
IV. ASSESSMENT OF BODY FAT stunting, when weight may be appropriate for
● It reveals the presence of severity of energy height and wasting when weight is very low for
imbalance. height.
● Body fat measurement above the standard is also ● Relatively independent of age between one and
an indicative of severe negative energy balance ten years. The presence of edema, obesity and/
● It is also an indicative of excess positive energy or poor linear growth may complicate the
balance. interpretation of this index and as a result, a
● It can be assessed through skinfold measurements. combination by weight for height and height for
● METHODS: age is often used.
- Physical and Chemical Analysis
- Ultrasonics

Crystal Gail M. Tangzo _BSND 2202

 ● Height for age reflects past nutritional status in Nutrient Evaluation Test
both children and adults, although genetic and
ethnic group must take into account. Vitamin A Plasma Retinol

● Iron Hemoglobin (Hb) level

Iodine Urinary Iodine Excretion (UIE)

BIOCHEMICAL AND CLINICAL ASSESSMENT
Zinc Serum Zinc Concentration
BIOCHEMICAL ASSESSMENT

● Measure of nutrients in blood, urine and other

biological samples. VITAMIN A DEFICIENCY (VAD)
● Provide most objective and quantitative data on
● Detected biochemically as deficient to a low
nutritional status.
plasma retinol level.
● The usefulness of biochemical tests is that they
● Plasma retinol concentration reflects an
provide indications of nutrient deficits long
individual’s vitamin A status
before clinical manifestations and signs appear.
● Serum retinol is typically maintained until hepatic
● Important in validation of data (under-reporting
stores are almost depleted
/overreporting of dietary intake surveys)
● ADVANTAGES:
- Objectivity
- Can detect early subclinical states of
nutritional deficiency
● Disadvantages:
- Costly, usually requiring expensive
equipment
- Time-consuming
- Difficult to collect samples
- Lack of practical standards of sample
collection
Note: the estimation of tissue, desaturation or blood activity ; laboratory
examination of tissue levels, nutrients and metabolites so they can
provide specific nutrition information as well as to identify the boarder IRON DEFICIENCY ANEMIA (IDA)
line prior to the development of symptoms of malnutrition ; use to
detect clinical deficiency ● The presence of anemia is one indication of the
COMMONLY USED MEASUREMENTS individual’s iron status, iron deficiency being a
major cause of anemia (WHO, 2001).
1. STATIC BIOCHEMICAL TEST ● Occurs if the amount of iron ingested from food
and absorbed in the body is too little to meet the
- Involves measurement of levels of a nutrient or a body’s demands.
metabolite in a preselected biopsy material that ● Chronic blood loss, increased iron reqs
reflects either the total body content of the ● Consequences: decreased physical
nutrient or the size of the tissue store most development, long-term cognitive impairment
sensitive to depletions are measured. and poor growth among infants, poor school
- Categories: performance among school-age children, risk of
a. Measurement of a nutrient in biologic low birthweight infants, and increased maternal
fluids or tissues mortality among pregnant women (WHO, 2001)
b. Measurement of the urinary excretion
rate of the nutrient

2. FUNCTIONAL TESTS

- “diagnostic tests to determine the sufficiency of

host nutriture to permit cells, tissues, organs,
anatomical systems or the host to perform
optimally the intended, nutrient-dependent
biologic function” (Solomons and Allen, 1993). IODINE DEFICIENCY DISORDER (IDD)

Lab Tests useful in Assessing Malabsorption ● Iodine Deficiency is common cause of

Syndromes preventable mental retardation; affects a
mother’s reproductive functions and impedes
1. Direct stool examination: stool is checked for children’s learning ability
weight (greater than normal weight suggest ● Universal salt iodization (USI) is the
malabsorption) and oily materials (excess fat in recommended strategy to eliminate IDD in a
stool suggest steatorrhea) population. USI can ensure optimal population
2. Chemical analysis of fecal fat: Fecal fat of iodine nutrition and protect generations of
greater than 7g/day when the diet includes 100 newborns from brain defect due to iron
g of fat/day indicates fat malabsorption deficiency.
3. Serum carotene: Low serum levels accompany
steatorrhea
4. Serum calcium: Low levels seen in calcium or
vitamin D malabsorption. (Steatorrhea can lead
to calcium and vitamin D malabsorption).
5. Xylose test: Test of carbohydrate absorption
6. Schilling test: Identifies vitamin B12
malabsorption
Lab Test for Assessing for Vitamin and Mineral Status
Crystal Gail M. Tangzo _BSND 2202
ZINC DEFICIENCY

● one of the major causes of growth retardation

among preschool children (Horz &Brown, 2004).
● contributes to the increased rates of infections
like diarrhea and pneumonia and leads to
cognitive function and memory impairment.

Common Laboratory Tests with Nutritional

Implication

● LIMITATIONS:

● Biochemical results could vary based on

different situations. For example, Sample
handling, standard procedures, contamination,
etc.
● Biochemical interpretation of the data obtained.
● Only medical technologists and medical
professionals could interpret the data result
efficiently and effectively.
● Normal values (ranges) could vary in different
individuals esp. when a present illness is already
present or when their nutritional intake is
different (ex: ethnicity)

Crystal Gail M. Tangzo _BSND 2202

 CLINICAL ASSESSMENT

Its basis of a clinical assessment are routine medical

history and a physical examination to detect physical
signs (observations) and symptoms (manifestation).

● Medical History: description of the patient and

environment, social and family factors, and specific data
on the medical history

● Physical Examination: changes, believed to be related

to inadequate nutrition, that can be seen or felt in the
superficial epithelial tissue (esp. skin, eyes, hair and
buccal mucosa, or in organs near the surface of the
body e.g. parotid and thyroid glands). (Jelliffe, 1966)

ADVANTAGES:

● Can cover more clients in a short time

● Inexpensive, no need for sophisticated
equipment

DISADVANTAGES:

● Non-specificity of signs
● Overlapping of deficient states
● Bias of the observer

LIMITATIONS:

● Subjective
● Could only be done by medical professions or
trained professionals
● Diagnosis could be highly supported with
biochemical data for validation
● Diagnosis could vary from different medical
professions.

Predominant clinical symptoms of common

nutritional problems

1. Protein-energy malnutrition (PEM): most

common form of malnutrition in the world today.

● Forms: Marasmus, Kwashiorkor, Nutritional Dwarfism

MARASMUS

• Common in infants (less than 2 y/o)

• Cause: severe deprivation or poor absorption of

Crystal Gail M. Tangzo _BSND 2202

 3. Anemia (IDA): with clinical symptoms that are
nutrients
nonspecific and should be confirmed with biochemical
• Develops slowly
Severe weight loss with gross loss of muscles test. Symptoms include paleness under the eyelids and
• Almost no subcutaneous fat and no edema nails.
• Growth: <60% weight-for-age
4. Goiter (IDD): Symptoms include; swelling of the neck,
• No fatty liver
• Anxiety, apathy lassitude and easy fatigability
• Appetite may be normal or poor
• Hair is sparse, thin, and dry, easily pulled
• Skin is dry, thin and wrinkled

KWASHIORKOR
5. Ariboflavinosis (Vit. B2 deficiency): Magenta red
• Common in older children (1-3 yrs)
tongue, sores at the angles of the mouth and folds of the
• Cause: Insufficient protein intake, infections
•Rapid onset: Acute PEM nose
• Some weight loss 6. Beriberi (Vit. B1/Thiamin deficiency): Muscle
• Some muscle wasting weakness, fatigability, heart enlargement, tachycardia,
• With Some body fat
edema (wet type)
• Growth: 60-80% weight-for-age
• Edema 7. Hypertension
• Enlarged liver; fatty liver
• Apathy, misery, irritability, sadness
• Loss of appetite
• Fine friable discolored hair
• Skin rash/skin lesions

NUTRITIONAL DWARFISM

• Short stature
• Retarded dental development
• Facial shape is inappropriate for their size DIETARY ASSESSMENT

● Study or activity intended to measure the quantity and

2. Vitamin A deficiency (VAD): a deficiency state quality of diets of individuals or population groups in an
that may or may not be manifested clinically. Its area for a given period of time
classification is done by ocular signs
● Produces qualitative and quantitative information
● Lack of vitamin A may result in xerophthalmia (dryness
of the eye), night blindness (inability to see in dim light), OBJECTIVES OF DIETARY ASSESSMENT (LEE,
sensitivity of eyes to bright light, and blindness in severe 2010)
cases; rough dry skin and membranes of nose and - To improve human health
throat; poor resistance to disease; poor growth. - To assess and monitor food and nutrient intake
- To formulate and evaluate government health
and agricultural policy
- To conduct epidemiologic research
- To use the data for commercial purposes

LIMITATIONS OF DIETARY ASSESSMENT (GIBNEY,

2010)

- Food intake is not a simple measure of one

variable such as weight or height, but requires
data in the intake of many different food items
- Food intake data are subject to many sources of
variability

DIETARY ASSESSMENT METHODS

● National Level

- Food balance sheets

- Market databases
- Universal product codes and electronic scanning
devices

● Household level

- Food account method

- List-recall method
- Inventory method
- Household food record
- Household budget survey

Crystal Gail M. Tangzo _BSND 2202

● Individual Level WEIGHED FOOD RECORD

- 24-hr food recall - The subject or their parent is instructed to weigh

- Repeated 24-hr food recall all the foods and beverages consumed by the
- Estimated food records subject during the specified time period
- Weighed food records - Used for diet counselling and for statistical
- Dietary history analysis involving correlation or regression w
- Food frequency questionnaire biological parameters
- Other methods
● STRENGTHS:
24 HR FOOD RECALL
- Most precise method for estimating usual food
- Most widely used method of obtaining info on and nutrient intakes of individuals
food intake from indiv
- Gives perfect snapshot of dietary intake of indiv ● LIMITATIONS:
- Assesses ave energy and nutrient intake - Respondents must be motivated, numerate and
● STRENGTHS: literate
- Respondents my change their usual eating
- Respondent burden is small pattern to simplify measuring or weighing
- Compliance is high process or to impress the investigator
- Quick (less than 20 mins) - High respondent burden, so individuals are less
- Easy to administer willing to cooperate
- Does not alter usual diet
- Relatively inexpensive DIETARY HISTORY
- Can be used w illiterate indiv - The collection of info not only about the freq of
- May be done by telephone interview intake of various foods but also about the typical
- Respondents are more likely to be a rep of the makeup of foods
population - Attempts to est the usual food intakes of indivs
● LIMITATIONS: over a relatively long period of time

- Flat slope syndrome: Overestimation of low ● Has 3 parts:

intakes and underestimation of high intaes 1. An interview of the usual diet
‘talking a good diet’ 2. A cross-check of this info by food group
- Not useful for assessing usual food or nutrient (frequency)
intakes 3. A 3-day record of food consumed in household
- need s thorough probing measures
- Foods eaten but not reported: missing foods; - Provides info on usual food intake patterns
foods not eaten but reported: phantom foods
- Single recall not a rep of usual intake ● STRENGTHS:
- Relies on memory
- Assesses meal patterns and not just intakes for
- Labor intensive data entry
a short period of time
REPEATED 24 HR FOOD RECALL - Data on all nutrients can be obtained

- 24 hr food recalls repeated during different ● LIMITATIONS:

seasons of the year to estimate ave food intake
- Not well-standardized
of indivs over a long period of time
- Bases on respondent judgments
- Measuring food composition patterns
- Lengthy interview process
ESTIMATED FOOD RECORDS - Requires highly trained interviewers
- Difficult and expensive to code
- The respondent is asked to record all foods and - Requires cooperative respondents
beverages eaten for a specified time period
- The amt of food consumed is est using simple FOOD FREQUENCY QUESTIONNAIRE
household devices such as c, tsp, and tbsp
- Food list w questions on usula freq of intake and
- Assesses individuals and group intake data
portion size
● STRENGTHS: - 2 TYPES:
1. Semi-quantitative ffq - collects portion
- Simple and convenient for a large sample size size info
- Problem of omission may be lessened and the 2. Non-quantitative ffq - focuses on the
foods are more fully described food groups
- Avoids reliance on memory - Most usual: Block Questionnaires; Fred
● LIMITATIONS: Hutchinson Cancer
- Research Center FFQ; Harvard University FFQ;
- Errors may arise from the inability of the Willet Questionnaire
respondent to adequately quantify portion sizes - Assesses usual pattern of food group intake
consumed
- Respondents should be thoroughly trained ● STRENGTHS:
- Respondents should be literate and motivated - Low respondent burden
- Samples may not be a rep of the population - Simple and inexpensive to obtain and analyze
- May alter dietary behaviors of respondents - Can be self-administered and can be scanned
by a machine

Crystal Gail M. Tangzo _BSND 2202

 - May be more rep of usual intake than other
methods
EVALUATING NUTRIENT INTAKES INDIVIDUALS
● LIMITATIONS:
Nutrient adequacy ratio
- Mixed or composite foods are a common source
of error, threat of double counting - Represents an index of adeq for a nutrient
- Requires respondents to perform a high level of based on the corresponding RENI
cognitive task in estimating the usual freq of - Formula: NAR = Subject’s daily intake of a
consumed foods and its portion sizes nutrient/RENI of that nutrient
- Quantification of nutrient intake may not be
calculated

DUPLICATE FOOD COLLECTION METHOD /

CHEMICAL ANALYSIS

- Identical portions of food and beverages

consumed are chemically analyzed at a lab for
nutrient content
- Assesses near actual nutrient intake of
respondents

● STRENGTHS:

- More accurate measurement of actual nutrient

intake

● LIMITATIONS:

- Expensive and requires a lot of effort in

preparing duplicate food items

ASSESSMENT OF NUTRIENT INTAKES

A. USE OF THE FOOD COMPOSITION TABLES

POPULATION GROUPS
- The FCT contains nutrient values based on
● Mean nutrient intake as percentage of
quantitative analysis of samples of each food
recommended nutrient intake
- It can be used to calculate the specific nutrient
● Recommended nutrient intake as the cut-off
consumption of indiv based from the food
value
consumption data obtained
● An arbitrary proportion of the recommended
B. Use of nutrient data banks nutrient intake

- Nutrient data banks or computer-stored nutrient

databases are fct transferred to and maintained
on a computer
- May be revised and updated readily
- Affected by:
➔ Updating of the database
➔ Nos. and types of food items available
➔ Ability to add foods or nutrients
➔ Ease of data entry and analysis
➔ Nutrients available
➔ Handling of missing nutrient values
➔ Handling of dietary supplements

C. Measurement errors in dietary assessment

- Random errors affect the precision of the

method and may be reduced by increasing the
no. of observations, but cannot be entirely
eliminated
➔ Sampling biases
➔ Respondent biases
➔ Interviewer biases
➔ Respondent memory lapses
➔ Incorrect estimations of portion sizes
➔ Supplement usage
➔ Flat slope syndrome
➔ Coding and computation errors

Crystal Gail M. Tangzo _BSND 2202