Nutritional state assessment - nutrition

Nutritional status: The state obtained through the relationship between the body's demand for nutrients and the nutrients obtained. We already know that both deficits and excesses of nutrients are detrimental to health, therefore, it is logical that the key to nutritional health is the balance between nutrient intake and body demand.

Knowledge of nutritional status gives us different capabilities:

• To verify the existence of vulnerable groups that maintain unhealthy eating habits.

• To demonstrate the correlation between certain consumption patterns and certain chronic degenerative diseases.

• Be aware of the nutritional status of at-risk populations such as the elderly, children and women during pregnancy and lactation.

• Design health policies to anticipate risk situations related to food consumption.

• Promote nutritional education.

The nutritional status of a person or population group is determined from several aspects.

Therefore, an accurate assessment requires a multidisciplinary study that includes fields such as:

• Dietetics

• Anthropometry

• Biochemistry.

• Immunology.

• Other ways.

Due to the variety of factors, a quality study would imply an important number of professionals and resources. In practice, access is not always possible, therefore, we insist only on the essential methods to ensure an acceptable diagnosis.

Dietary surveys: Dietary surveys are a quick and practical method that gives us access to information on the nutrient intake of an individual or group. The data obtained on food composition in the laboratory are compared with the intakes and with the nutritional objectives for a final assessment of the different indices, in order to reach the most complete criterion possible on the nutritional status resulting from the diet.

Limitations of dietary surveys:

• It is not an accurate method in terms of quantities and quality of nutrients ingested.

• The results are not accurate because only dietary data are used in the final evaluation.

Some judgments to classify dietary surveys.

According to the context in which it is applied:

• National surveys.

• Family surveys or in small groups.

• Individual surveys.

According to the intake data taken, current or past:

• Prospective: Techniques that study current intake. Examples: chemical analysis, food composition tables [TSA].

• Retrospective: Techniques conducted to study past intake. They can measure immediate, recent or distant past intake. Examples: 24-hour recall, frequency of consumption, dietary history.

According to the ways of collecting data, they are classified as follows:

• Indirect: through balance sheets.

• Direct: examples: records and interviews.

Anthropometric Measurements

To define the body structure and composition, it is carried out through the collection of data on length and weight parameters of the organism, to then compare with reference values that contemplate aspects such as age, sex, as well as the physiopathological states in which the individuals are found. Although anthropometric measurements are largely subject to genetic factors, they are also linked to environmental factors, a dimension that includes nutrition in a leading role, especially in the growth stages.

indices that are calculated from anthropometric measurements:

• body mass index [BMI]: the body mass index gives way to the diagnosis of underweight, normal weight, overweight and obesity, based exclusively on the height and weight of the individual.

• Basal energy expenditure [BEE]: Energy expenditure at rest.

• Body fat: By analyzing the subcutaneous folds in different areas of the body, an assessment can be made of the subcutaneous fat mass, which constitutes about 50% of the total fat mass.

• Muscle mass: It is performed by calculating the muscular perimeter of the arm.

Biochemical data: They are based on the study of different biological models used to assess nutritional status. They are defined by the high degree of objectivity due to the relentless quality control demanded in laboratories.

Types of analysis performed:

• Static: They calculate the actual nutrient value in a specific model. For example, they measure iron in serum.

• Functional: They check the nutrient content by quantifying the activity of an enzyme that is supported by the nutrient of interest.

• Immunological parameters: These are the testing of immunological parameters that provide access to the detection of malnutrition in apparently healthy patients.

Nutritional status has an impact on the immune system, so there have been cases in which supposedly healthy patients, who even present normal anthropometric parameters, suffer from subclinical malnutrition, presenting reduced cellular immunity.

Immunological parameters analyzed:

• T lymphocyte count.

• Delayed hypersensitivity skin reactions.

• Lymphoblastic transformation tests.

• Detection of immunoglobulin status.

Other methods to determine nutritional status:

• Clinical assessment of nutritional status: It is used whenever the level of malnutrition is given specifically with a nutrient, but also in a generalized way. Malnutrition is so evident that clinical signs are manifested in certain organs or areas of the body such as the eyes, lips, gums, etc. It can be limited to a visual diagnosis.

• Functional tests: The most characteristic format is the respiratory function test, which is used to indirectly assess muscle mass through the functioning of the respiratory muscles.

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