Nutritional Status Assessment: Mastering Knowledge, Efficient Application

1. Concept:

Nutritional Status (NS) is a set of functional, structural, and biochemical characteristics reflecting the body’s ability to meet its nutritional needs. NS is the result of dietary intake and the body’s utilization of nutrients.

Good NS reflects a balance between dietary intake and the body’s health status.

2. Factors Affecting Nutritional Status:

Nutritional status is influenced by various factors, including:

• Internal factors: Genetics, different physiological stages (age, sex, pregnancy, lactation), diseases,…

• External factors: Climate, weather, socioeconomic level, food culture, nutrition education, access to food sources,…

Note: Internal and external factors can interact and influence NS in complex ways.

3. Nutritional Status Assessment:

Nutritional status assessment is the process of collecting, analyzing information and data on NS and making judgments based on that information. Assessing NS helps to:

• Determine the level of nutrient needs met by the body.

• Early detection of NS issues.

• Develop appropriate nutritional intervention plans.

• Monitor the effectiveness of nutritional interventions.

4. Methods of Nutritional Status Assessment:

• Dietary intake and eating habits investigation: Determining the amount of food and nutrients consumed daily.

• Clinical method: Physical examination to detect clinical signs of malnutrition.

• Anthropometric method: Measuring body parameters such as height, weight, arm circumference, waist circumference,…

• Biochemical method: Blood and urine tests to determine nutrient levels in the body.

• Investigation of disease and death rates: Analyzing the relationship between NS and disease incidence and mortality.

• Ecological factor assessment: Identifying environmental factors affecting NS.

Note: These investigative methods can be combined to provide comprehensive and accurate information about nutritional status.

5. Anthropometric Method:

The anthropometric method is the most important method in nutritional status assessment, especially in assessing the nutrition of children.

Advantages:

• Simple, safe, applicable to large samples.

• Inexpensive equipment, easy to transport.

Disadvantages:

• Difficult to assess short-term changes.

• Less sensitive to specific NS (micronutrients,…).

• Unable to distinguish between NS caused by internal or external factors, due to diet or disease,…

6. Food Consumption Frequency Determination:

Advantages:

• Fast, cheap, not burdensome for research subjects.

• Investigate the relationship between eating habits/food consumption levels and related diseases.

Disadvantages:

• Cannot accurately assess nutritional status.

7. 24-Hour Recall:

Characteristics:

• Difficult to determine for individuals.

• Requires accurate information collection, labor-intensive.

8. Anthropometric Indices:

Classification of anthropometric size groups:

• Body weight: Weight.

• Length dimensions: Recumbent length, standing height.

• Body structure and energy and protein reserves: Surface soft tissue, subcutaneous fat layer and muscle.

Anthropometric indices to note for individuals aged 20-60:

• Body fat percentage.

Anthropometric indices to note for individuals over 60 years old:

• Knee height (shin length): Estimate relative height.

Basic dimensions for all age groups:

• Height.

• Weight.

• Triceps skinfold thickness.

• Arm circumference.

Note: Anthropometric indices should be compared with reference charts to assess nutritional status.

9. Weight Measurement:

• Most commonly used index in anthropometric research.

• Infant scale: Used for infants who cannot stand.

• Platform scale: Used for adults.

10. Height Measurement:

• Points of contact with the plane when measuring height for children: Heels, calves, buttocks, shoulders, occiput.

• Note when measuring height with children using recumbent length: Subtract 0.7 cm from the measured result.

11. BMI (Body Mass Index):

• Formula: BMI = Weight (kg) / Height (m)².

• Advantages: Assess weight-for-height relationship independent of age, assess chronic NS.

• Disadvantages: Cannot distinguish between fat weight (obesity) or muscle weight (not obesity).

12. Z-score:

• Formula: (Measured size – Population reference mean) / Population reference standard deviation.

• Normal limit threshold according to Z-score: -2SD < Z-score < 2SD.

13. Nutritional Status Assessment Based on Anthropometric Indices:

• Weight for age: General assessment, not specific value.

• Height for age: Assess long-term effects.

• Weight for height: Assess acute nutritional status.

• Combined SDD (chronic and acute): Both height-for-age and weight-for-height indices are below the threshold.

Note: Anthropometric indices should be assessed in conjunction with information on medical history, diet, and lifestyle to make accurate conclusions about nutritional status.

14. Other Indices to Note:

• Subcutaneous fat layer thickness measurement: To eliminate the case of excess weight due to muscle system development in athletes, should be done in addition to BMI.

• Waist-to-hip ratio: Helps classify obesity.

15. Physical Examination:

• Most valuable method for detecting NS.

• Disadvantage: Difficult to detect if symptoms are subtle.

Note: Nutritional status assessment should be performed by nutrition experts or qualified physicians.

Conclusion:

Nutritional status assessment is crucial for ensuring the health of each individual. Mastering knowledge about concepts, influencing factors, assessment methods, and anthropometric indices is essential for efficient application in daily life.