terapi obat obat Nutrition assessment.ppt

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1. Slides current until 2008
Nutrition assessment
Section 2 | 2 of 6
Curriculum Module III-5 | Nutrition therapy

2. Nutrition assessment
Curriculum Module III-5
Slide 2of 25
ACTIVITY
Slides current until 2008
Identify the factors that influence
dietary intake

3. Nutrition assessment
Curriculum Module III-5
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Slides current until 2008
Assessment of health status /1
•Socio-economic status and culture
•Dental health
•Screening for co-morbidity, e.g.
coeliac disease

4. Nutrition assessment
Curriculum Module III-5
Slide 4of 25
Slides current until 2008
Assessment of health status /2
•Laboratory tests to determine clinical
status
–fasting glucose, HbA
1clevel
–lipid profile (cholesterol —HDL, LDL)
–haemoglobin, ferritin, creatinine, U and
E’s, thyroid function
•Screening for complications e.g.
cardiovascular, renal disease
•Current medication and nutrient
supplements

5. Nutrition assessment
Curriculum Module III-5
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Slides current until 2008
•Body weight
•Height
•Agreed acceptable weight
–using standard height/weight tables
Anthropometric measurements

6. Nutrition assessment
Curriculum Module III-5
Slide 6of 25
Slides current until 2008
Weight and height measurements to
calculate BMI:
BMI = weight in kg/(height in m)
2
Standard BMI normograms:
21-25 desirable
25-30 overweight
>30 obese
Geographical variations exist
Body Mass Index (BMI)

7. Nutrition assessment
Curriculum Module III-5
Slide 7of 25
ACTIVITY
Slides current until 2008
Body Mass Index (BMI)
Calculate the individual BMI of your
fellow participants

8. Nutrition assessment
Curriculum Module III-5
Slide 8of 25
Slides current until 2008
Waist-to-hip ratio (WHR)
•Central adiposity –important
cardiovascular risk marker
•High WHR –increased risk
•WHR used to define body shape
•A pear-shaped body is preferable to an
apple-shaped body

9. Nutrition assessment
Curriculum Module III-5
Slide 9of 25
Slides current until 2008
Measuring WHR
The hip circumference is
the largest circumference
at the posterior extensive
of the buttocks
The waist circumference
is the smallest
circumference below the
rib cage and above the
umbilicus

10. Nutrition assessment
Curriculum Module III-5
Slide 10of 25
Slides current until 2008
Central obesity
plus any two of the following four
factors:
-raised triglycerides
-reduced HDL cholesterol
-raised blood pressure
-raised fasting blood glucose
IDF definition of the metabolic
syndrome

11. Nutrition assessment
Curriculum Module III-5
Slide 11of 25
Slides current until 2008
Dietary assessment
•Dietary history
–usual food intake recorded through
interview
•Dietary recall
–food and drink consumed in
previous 24 hours (24-hour recall)

12. Nutrition assessment
Curriculum Module III-5
Slide 12of 25
Slides current until 2008
Dietary history and recall tips
Ask for or check:
•Food pattern on a normal day
•Size of portions at home
•Daily/weekly/monthly purchases
•Eating out and take-away –frequency
•Food favourites –self and family
•Food products, e.g. skimmed or whole
milk
•Hunger patterns

13. Nutrition assessment
Curriculum Module III-5
Slide 13of 25
ACTIVITY
Slides current until 2008
Disadvantages of the dietary recall
method

14. Nutrition assessment
Curriculum Module III-5
Slide 14of 25
Slides current until 2008
•Food frequency questionnaire
•Prospective food records
•Weighed food records
Detailed dietary assessment
methods

15. Nutrition assessment
Curriculum Module III-5
Slide 15of 25
Slides current until 2008
Groups with special dietary needs
•Pregnant women
•People with a gastro-intestinal
condition, such as coeliac disease
•Older people

16. Nutrition assessment
Curriculum Module III-5
Slide 16of 25
ACTIVITY
Slides current until 2008
Interpreting assessment data
Analyse the information collected from the
assessment process
What further considerations are necessary
before the management plan is agreed on?

17. Nutrition assessment
Curriculum Module III-5
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Summary
•Detailed assessment
•Multiple factors for assessment
•Variety of assessment methods
•Special groups

18. Nutrition assessment
Curriculum Module III-5
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Slides current until 2008
Giving nutrition education to people
without first analysing their nutritional
and health status is like sailing a ship in
a fog without a compass, charts or
information about the weather and
currents.

19. Nutrition assessment
Curriculum Module III-5
Slide 19of 25
Slides current until 2008
Review question
1. Which of the following is NOTa goal of
nutritional assessment?
a.To identify malnutrition (under and
overweight)
b.To identify those at risk of nutritional
deficiencies
c.To identify eating habits that may be
associated with poor diabetes control
and increased risk of cardiovascular
disease
d.To allow people to choose their own
treatment plan

20. Nutrition assessment
Curriculum Module III-5
Slide 20of 25
Slides current until 2008
Review question
2. In European populations, which BMI
is classified as obese?
a.24
b.26
c.28
d.31

21. Nutrition assessment
Curriculum Module III-5
Slide 21of 25
Slides current until 2008
Review question
3. When describing central adiposity,
which fruit shape is associated with
an increased risk of cardiovascular
disease?
a.Apple
b.Pear
c.Orange
d.Melon

22. Nutrition assessment
Curriculum Module III-5
Slide 22of 25
Slides current until 2008
Review question
4. Which of the following is NOTincluded
in the IDF definition of the metabolic
syndrome?
a.Raised fasting blood glucose
b.Raised blood pressure
c.Reduced LDL cholesterol
d.Raised triglycerides

23. Nutrition assessment
Curriculum Module III-5
Slide 23of 25
Slides current until 2008
Review question
5. Which of the following is NOTused
to assess diet in normal clinical
practice
a.Food diaries
b.Weighed food records
c.Diet histories
d.Diet recall

24. Nutrition assessment
Curriculum Module III-5
Slide 24of 25
Slides current until 2008
Answers
1.d
2.d
3.a
4.c
5.b

25. Nutrition assessment
Curriculum Module III-5
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Slides current until 2008
References
1.American Diabetes Association. Diabetic Nephropathy. Diabetes Care 2004; 27(suppl 1).
2.American Diabetes Association. Dyslipidemia Management in Adults with Diabetes.
Diabetes Care 2004; 27(suppl 1): S68-71.
3.American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care
2004; 27(suppl 1): S19.
4.Anil Kapur, et al. Novovare Interactive Nutrition Assistant -A computer aided Interactive
Nutrition ManagementProgram, Novo Nordisk. Diabetes Update Proceedings 1997.
5.Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian
Diabetes Association 2003 Clinical Practice Guidelines for the Prevention and
Management of Diabetes in Canada. Can J Diabetes 2003; 27(suppl 2): S19.
6.International Diabetes Federation. www.idf.org
7.Maryniuk MD. The new shape of medical nutrition therapy. Diabetes Spectrum 2000;
13(3): 122-24.