Transcript Document

Welcome to Seminar
on
Nutrition Assessment and
Management in
Family Medicine
Part - 1
Meera Kaur, PhD, RD
Assistant Professor, Family Medicine
[email protected]
Objectives
• To understand the importance of routinely
incorporating nutrition into clinical practice for all
ages.
• To identify methods to assess the nutritional status of
healthy clients and those with acute or chronic illness.
• To identify the prevalence, risk factors and usual
physical findings associated with malnutrition and
obesity.
• To assess which patient would benefit from additional
nutrition counseling.
• To be timely- little amount of clinical time and a lot of
ground to cover.
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For all your nutrition needs…
My Goals for you are to:
enable you to feel comfortable
with basic nutrition questions
asked by your patients.
think about nutrition as a
preventative health strategy,
and to take action.
know where and when to
consult an RD.
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What is Nutrition Assessment?
Nutrition Assessment is an in-depth evaluation of
both objective and subjective data related to an
individual’s food and nutrient intake, lifestyle and
medical history
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Why nutrition assessment is important?
• Nutrition-related diseases are leading causes of
morbidity and mortality around the globe
• Increasing need for better preventative health strategies.
– Want to find help for these people before it is too late.
• Most people’s eating habits can be improved.
– Health Canada Canadian Community Health Survey :
Nutrition (2006)
– Malnutrition is common .
• 40-65% of hospitalized population are malnourished (Singh, Nutrition,
2006).
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Canadian Community Health Survey (2006)
Canadians consume:
– 31% of calories from fat.
• Main contributor is pizza, sandwiches, subs,
burgers, hot dogs
– 70% of children, and 50% of adults do not eat
enough fruits and vegetables.
– 33% of children and 67% adults do not get
enough milk products.
– 59% of adults were overweight or obese.
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Obesity Trends Among Canadian
and U.S. Adults, 1985
No Data
<10%
10%-14%
15-19%
20%
AH Mokdad, Unpublished data
PT Katzmarzyk, Can Med Assoc J 166:1039-1040, 2002
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Obesity Trends Among Canadian
and U.S. Adults, 2000
No Data
<10%
10%-14%
15-19%
20%
AH Mokdad, Unpublished data
PT Katzmarzyk, Can Med Assoc J 166:1039-1040, 2002
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Components of nutritional assessment
• What Nutrition Assessment includes:
– Nutritional genomics
– Anthropometrical measurement
– Social/ life style assessment
– Biochemical measurement
– Clinical
(Medical
hx.,
Supplements,
Diet/Social hx, Review of systems,
Physical examination)
– Subjective Global assessment
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Nutritional Genomics
– Nutritional genomics is a science studying the
relationship between human genome, nutrition
and health. It can be divided into two disciplines:
– Nutrogenomics: studies the effect of nutrients on
health through altering genome, proteome,
metabolome and the resulting changes in
physiology.
– Nutrogenetics: studies the effect of genetic
variations on the interaction between diet and
health with implications to susceptible subgroups.
Anthropometrical Measurement
• Weight (Dry vs. Wet)
• Height
• Waist circumference vs. Body Mass Index
– BMI is not a direct measure of body fatness, varies
with body composition.
– Can adjust for age.
Waist Circumference allows us to assess body fatness
• >102 cm male and >88 cm women = increased health risk.
• Apple vs Pear
• Skinfold measurement
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Measurements of lean body mass,
body fat and bone mass
Social and Life Style Assessment
• Lifestyle assessment
– Employment, exercise, who they live with/ who
does grocery shopping and cooking.
– Walking
– Taking medications
– Managing money
– ETOH
• Special diets in past
• Dietary Hx
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24-Hr Recall
Food frequency
Usual intake
Food record
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