A number of nutritional screening and assessment tools are available for use by nurses, registered dietitians, physicians and other health care professionals to detect malnourishment or risk of malnourishment. No single assessment tool will provide a measure of comprehensive nutritional status. It is important that a nutritional assessment gathers historical, physical and laboratory data. You typically will not require frequent nutritional screening unless there is a disease or physical ailment present.
Helpful information can be gathered from a record of your weight history, medical history and dietary practice history. This may be collected from medical records, or you may be asked to keep a food diary for a number of days. The most important historical data are changes in weight. A change of 10 percent or more is considered clinically significant and warrants further investigation.
A nutritional screening physical assessment will consist of a number of measurements. These will include body mass index -- also known as BMI. A BMI of less than 18.5 is considered at risk for malnutrition, 18.5 to 24.9 is desirable and over 24.9 is considered obese. In addition, areas of the body where cell replacement occurs at a high rate are likely to show signs of malnutrition. Therefore hair, oral, eye and skin examination will be performed. Loss of hair or changes in skin may indicate poor nutrition.
Your health care professional may decide to use laboratory tests such as blood tests to obtain further information that may be useful in your nutritional assessment. Blood tests may reveal electrolyte imbalances -- in the case of under- or over-hydration and purging -- nutritional anemia, vitamin C and folate deficiency. When deficiency is suspected, a number of specific nutrient levels -- such as thiamine, riboflavin, vitamin A, C, D, E, B12, zinc and iron-- can be measured.
You also may be requested to fill out a standard questionnaire to elicit specific information about your health and eating habits. Typically these are brief -- taking perhaps 10 minutes to complete. Examples include the Mini-Nutritional Assessment, the Subjective Global Assessment and the Nutrition Risk Index. All dietary assessment methods have limitations. The selection of a dietary assessment tool will depend on many factors; the most important is the objective of your consultation.
- Clinical Nutrition for Surgical Patients; Nutrition Screening and Assessment; Mary Marian et al.
- Nutrition Therapy: Advanced Counseling Skills: The Assessment Process; Kathy King et al.
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This article reflects the views of the writer and does not necessarily reflect the views of Jillian Michaels or JillianMichaels.com.