Nutritional Assessment

Introduction
Nutritional assessment is the systematic process of collecting and interpreting

information in order to make decisions about the nature and cause of nutrition related health

issues that affect an individual.

It is used to determine the nutritional status of individual or population groups as

influenced by the intake and utilization of nutrients.

The nutritional status is determined by a complex interaction between internal factors and

external environmental factors.

Internal factors like age; gender; nutrition; behavior and physical activity.

External environmental factors like; food safety; cultural and social circumstances.

Purpose of nutritional assessment

The purpose of nutritional screening is to rapidly identify patients at high nutritional risk.

The purpose of nutritional assessment, however, is to define a patient’s nutritional status,

to define clinically relevant malnutrition and to monitor changes in nutritional status.

Methods of nutritional assessment

Nutrition is assessed by two methods

1.Direct Method
2.Indirect Method

Direct Method of Nutritional assessment

Nutritional assessment can be done using the ABCD methods. These refer to the following:

• Anthropometric method

• Biochemical/Laboratory method

• Clinical examination

• Dietary evaluation method

Anthropometric Methods
Anthropometry is the measurement of the size, weight, and proportions of the body.

Common anthropometric measurements include weight, height, MUAC, head circumference,

and skinfold.

Anthropometric measurements can be used to identify nutritional status in the population

more correctly by calculating Composite Score of the measurements and it is a non-invasive and

relatively correct way of identification.

Anthropometric Measurements:
• Mid-arm circumference

• Skinfold thickness
 • Head/chest ratio

• Head circumference

Biochemical/Laboratory Method:

Biochemical or laboratory methods of assessment include measuring a nutrient or its

metabolite in the blood, urine or other tissues that have a relationship with the nutrient. An

example of this method would be to take blood samples to measure levels of glucose in the body.

This method is useful for determining if an individual has diabetes.

Clinical examination:
Clinical methods of assessing nutritional status involve checking signs of deficiency at

specific places on the body or asking the patient whether they have any symptoms that might

suggest nutrient deficiency from the patient.

Clinical signs of nutrient deficiency include: pallor (on the palm of the hand or the

conjunctiva of the eye), Bigot’s spots on the eyes, pitting edema, goiter and severe visible

wasting.

Dietary evaluation Method:

Dietary assessment involves the collection of information on food and drink consumed

over a specified time that is coded and processed to compute intakes of energy, nutrients and

other dietary constituents using food composition tables.

2. Indirect Method of nutritional assessment

These include three categories:

• Ecological variables Including crop production

 • Economic factors e.g. per capita’ income’ population density & social habits

• Vital health statistics particularly infant & under 5 mortality.

Anthropometric Measurements `
Anthropometric measurements refer to assessments of the body’s height, weight, and

other measurements taken without invading the body. Explore the tools, purpose, and methods of

anthropometric measurements. Understand the different fields that use anthropometric

measurements, including healthcare, as well as athletics and research. Anthropometric

measurements are useful in many fields. For example, athletes understand that body size and

composition are important factors in sports performance. Health care professionals rely on body

measurements to evaluate a patient’s overall health. For example, body mass index, or BMI, is a

measurement of a person’s weight-to-height ratio.

Measuring procedure
Weight Measurement
Measuring Weight Accurately at Home:

• Use a digital scale

• Have the child or teen remove shoes and heavy clothing, such as sweaters.

• Have the child or teen stand with both feet in the center of the scale.

• Record the weight to the nearest decimal fraction (for example, 55.5 pounds or 25.1

kilograms).

Height Measurement
(Height ×2.54=cm÷100=m)
 Lightly mark where the bottom of the headpiece meets the wall. Then, use a metal tape to

measure from the base on the floor to the marked measurement on the wall to get the height

measurement. Accurately record the height to the nearest 1/8th inch or 0.1 centimeter.

Demi-span
Demi-span is measured as the distance from the middle of the sternal notch to the tip of

the middle finger in the coronal plane. Height is then calculated from a standard formula.

For Men: Height (cm) = 67.51 + (1.29 x demi-span) – (0.12 x age) + 4.13

For Women: Height (cm) = 67.51 + (1.29 x demi-span) – (0.12 x age)

Waist Circumference
• Start at the top of your hip bone

• Then bring the tape measure all the way around your body, level with the belly button.

• Make sure it’s not too tight and that it’s straight, even at the back. Don’t hold your breath

while measuring.

• Check the number on the tape measure right after the exhale

Limbs Circumference
Mark a point on the arm halfway between the acromion and olecranon. This marks the

vertical level at which the circumference will be measured. It is important that this measurement

is made with the arm flexed, otherwise the tape takes an oblique course across the upper arm,

and the mid-point is too high up. 10.

BMI
 Body mass index (BMI) is a value derived from the mass (weight) and height of a person.

The BMI is defined as the body mass divided by the square of the body height, and is expressed

in units of kg/m2, resulting from mass in kilograms and height in meters.

The formula is BMI = kg/m2 where kg is a person’s weight in kilograms and m2 is their

height in meters squared.

Skinfold Measurements
A skinfold calliper is used to assess the skinfold thickness, so that a prediction of the total

amount of body fat can be made. This method is based on the hypothesis that the body fat is

equally distributed over the body and that the thickness of the skinfold is a measure for

subcutaneous fat.

The sum of four skinfolds:

To estimate the total amount of body fat, four skinfolds are measured:

• Biceps skinfold (front side middle upper arm

• Triceps skinfold (back side middle upper arm)

• Subscapular skinfold (under the lowest point of the shoulder blade)

• Suprailiac skinfold (above the upper bone of the hip

Desirable Body Weight

Desirable body weight is a clinical standard that incorporates biometric variables

including height, gender, and age. It is used to determine the proper dosage of prescribed

medications for patients, and in sports to measure body weight in athletes according to a

classification scale.
For Men=106lb for the first 5 feet and 6lb for each additional inch

For Women=100lb for the first 5 feet and 5lb for each additional inch

Anthropometric Assessment
Weight: --------------------pounds/2.2=--------------kg

Height: -----------inches×2.54=---------cm/100--------m

Demi-span: ------------------

Waist Circumference: -----------inches×2.54=------------cm

Hip Circumference: -----------inches×2.54=---------cm

Waist to Hip ratio: (waist/Hip measurement) = ----------

BMI:(weight in kg/Height in m²) =------------------

Ideal body weight (IBW):

(106lb for first 5 feet)

(For Men 106+6 × additional inches)

(For women 105+5× additional inches in height) =---------------

Usual Body Weight (UBW):(Actual weight /UBW×100) =----------

 Anthropometric Assessment
Weight: --------------------pounds/2.2=--------------kg

Height: -----------inches×2.54=---------cm/100--------m

Demi-span: ------------------

Waist Circumference: -----------inches×2.54=------------cm

Hip Circumference: -----------inches×2.54=---------cm

Waist to Hip ratio: (waist/Hip measurement) = ----------

BMI:(weight in kg/Height in m²) =------------------

Ideal body weight (IBW):

(106lb for first 5 feet)

(For Men 106+6 × additional inches)

(For women 105+5× additional inches in height) =---------------

Usual Body Weight (UBW):(Actual weight /UBW×100) =----------

 Anthropometric Assessment
Weight: --------------------pounds/2.2=--------------kg

Height: -----------inches×2.54=---------cm/100--------m

Demi-span: ------------------

Waist Circumference: -----------inches×2.54=------------cm

Hip Circumference: -----------inches×2.54=---------cm

Waist to Hip ratio: (waist/Hip measurement) = ----------

BMI:(weight in kg/Height in m²) =------------------

Ideal body weight (IBW):

(106lb for first 5 feet)

(For Men 106+6 × additional inches)

(For women 105+5× additional inches in height) =---------------

Usual Body Weight (UBW):(Actual weight /UBW×100) =----------

 Anthropometric Assessment
Weight: --------------------pounds/2.2=--------------kg

Height: -----------inches×2.54=---------cm/100--------m

Demi-span: ------------------

Waist Circumference: -----------inches×2.54=------------cm

Hip Circumference: -----------inches×2.54=---------cm

Waist to Hip ratio: (waist/Hip measurement) = ----------

BMI:(weight in kg/Height in m²) =------------------

Ideal body weight (IBW):

(106lb for first 5 feet)

(For Men 106+6 × additional inches)

(For women 105+5× additional inches in height) =---------------

Usual Body Weight (UBW):(Actual weight /UBW×100) =----------

 Anthropometric Assessment
Weight: --------------------pounds/2.2=--------------kg

Height: -----------inches×2.54=---------cm/100--------m

Demi-span: ------------------

Waist Circumference: -----------inches×2.54=------------cm

Hip Circumference: -----------inches×2.54=---------cm

Waist to Hip ratio: (waist/Hip measurement) = ----------

BMI:(weight in kg/Height in m²) =------------------

Ideal body weight (IBW):

(106lb for first 5 feet)

(For Men 106+6 × additional inches)

(For women 105+5× additional inches in height) =---------------

Usual Body Weight (UBW):(Actual weight /UBW×100) =----------

 Biochemical Assessment
CBC
A complete blood count (CBC) is a blood test used to evaluate your overall health

and detect a wide range of disorders, including anemia, infection and leukemic. The CBC

can evaluate your overall health and detect a variety of disease and conditions such as

infections' anemia. Complete blood count test measures several components and features

of your blood, including:

• Red blood cells, which carry oxygen

• White blood cells, which fight infection

• Hemoglobin, the oxygen-carrying protein in red blood cells

• Hematocrits, the proportion of red blood cells to the fluid component, or plasma, in

your blood

• Platelets, which help with blood clotting

The complete blood count generally includes the following components:

• White blood cell count (WBC or Leukocyte count)

• WBC differential count.

• Red blood cell count (RBC or erythrocyte count)

• Hematocrit (Hct)

• Hemoglobin (Hbg)

• Mean corpuscular volume (MCV)

• Mean corpuscular hemoglobin (MCH)

 The Normal Ranges of Component in CBC Chart

Components Values and Ranges

White blood cell count (WBC)
White blood cell (WBC) differential count
4,300 to 10,800 cells per cubic millimeter
(cm)
The cells in a differential count are
granulocytes, lymphocytes,
monocytes, eosinophils, and basophils

Red cell count (RBC) 4.2 to 5.9 million cells/cm

Platelet count 150,000 to 400,000 per cm

Serum Albumin
A serum albumin test is a simple blood test that measures the amount of albumin in your

blood. Having surgery, getting burned, or having an open wound raises your chances of having a

low albumin level.

If none of those apply to you and you have an abnormal serum albumin level, it may be a

sign that your liver or kidneys aren’t working correctly. It could also mean that you have a

nutritional deficiency.

The normal range is 3.5 to 5.5 g/dL or 35-55 g/liter. This range may vary slightly in different

laboratories.

Prealbumin
Prealbumin is a protein made in your liver. Prealbumin helps carry thyroid hormones and

vitamin A through your bloodstream. It also helps regulate how the body uses energy. If your

Prealbumin levels are lower than normal, it may be a sign of malnutrition. Low
 Prealbumin scores mean that you are likely to need a nutritional assessment. Low Prealbumin

scores may also be a sign of liver disease, inflammation, or tissue death (tissue necrosis).

Albumin Risk Stratification

PREALBUMIN LEVEL RISK LEVEL

<5.0 mg per dL (<50 mg per L) Poor prognosis
5.0 to 10.9 mg per dL (50 to 109 mg per L) Significant risk; aggressive nutritional support
indicated
11.0 to 15.0 mg per dL (110 to 150 mg per L) Increased risk; monitor status biweekly
15.0 to 35.0 mg per dL (150 to 350 mg per L) Normal

LFT

LFT Stands for “Liver Function test” refer to measurements of serum bilirubin, alkaline

phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma

glutamyl transpeptidase (GGT), and albumin, but they should also include the prothrombin time

(PT). In general, conditions affecting the liver cell (hepatitis) cause a rise in AST and ALT,

whereas biliary tree disorders (cholestasis) cause raised ALP and GGT. It is important to

recognize that these enzymes are also present in other sites of the body, and when interpreting

isolated elevation intrahepatic sources should be considered (Table 78-1). Raised liver enzymes

often overlap between hepatitis and cholesteric patterns in clinical practice. Aminotransferases

(AST, ALT) can also be elevated in both intra- and extrahepatic cholestasis.

RFT
Kidney Function Test (KFT/RFT Test) is a profile of biochemistry blood tests that are

useful to assess the renal function. KFT test is also commonly known as Renal Function Test,

RFT Test, Kidney Profile or Kidney Panel. At HOD, the KFT Test includes several parameters
 such as Creatinine, Potassium, Phosphorous, Uric Acid, Chloride, Sodium, Blood Urea,

Blood Urea Nitrogen, and Calcium.

Urine samples
Clinical urine tests are examinations of the physical and chemical properties of urine and its

microscopic appearance to aid in medical diagnosis. The term urinalysis—a portmanteau of the

word urine and analysis.

Urine analysis involves assessment of the physical properties of urine, such as color and

clarity; chemical analysis using a urine test strip; and microscopic examination. Microscopic

examination is not always included: it may be reserved for samples that have abnormal results on

preliminary examinations, or performed at the healthcare provider’s request. Test strips contain

pads impregnated with chemical compounds that change color when they interact with specific

elements in the urine; for example, nitrite, a compound produced by some bacteria that cause

urinary tract infections, and leukocyte esterase, an enzyme found in white blood cells (WBCs)

which acts as an indicator of the number of WBCs in the urine. The intensity of the color change

correlates roughly with the concentration of each compound.

Electrolyte Testing
Electrolytes are electrically charged minerals that help control the number of fluids and

the balance of acids and bases in your body. They also help control muscle and nerve

activity, heart rhythm, and other important functions. An electrolyte panel, also known as a

serum electrolyte test, is a blood test that measures levels of the body’s main electrolytes:

• Sodium, which helps control the amount of fluid in the body. It also helps your nerves

and muscles work properly.

 • Chloride, which also helps control the amount of fluid in the body. In addition, it

helps maintain healthy blood volume and blood pressure.

• Potassium, which helps your heart and muscles work properly.

Clinical Examination

Clinical signs and symptoms

Clinical data provide information about the individual medical history, including acute

and chronic illness and diagnostic procedures ,therapies ,or treatment that may increase nutrients

need or include malabsorption .Physical signs of malnutrition can be documented during the

nutrition interviews and are important part of assessment process .Clinical assessment includes

checking for visible signs of nutritional deficiencies such as bilateral pitting which is loss of

muscle and fat tissue as a result of low energy intake and nutrient loss from infection, hair loss

,and changes in hair color .It also includes taking a medical history to identify comorbidities with

its nutritional implications, other medical complications ,usage of medication with nutrition

related side effects ,food and interaction.

Assessment of nutritional status in infants under 6 months involves checking for clinical

signs of acute malnutrition such as visible wasting, ineffective breast feeding and recent weight

loss or failure to gain weight, as well as risk factors such as insufficient breast milk or absence of

the mother. Clinical assessment for this age group should also assess infant feeding practices

ensure access to breast milk.

 Clinical nutrition assessment also includes checking for or asking clients about symptoms

infection that can increase nutrient needs e.g., fever and nutrient loss. diarrhea and vomiting as

well as medical conditions that impair digestion and nutrition absorption and increase the risk of

developing malnutrition. Medical records should provide information about illness

hospitalization, operation, diagnostic test and therapies and medications that can nutrition status.

Example of physical signs of nutritional problem

ASSESSMENT CLINICAL SINGS POSSIBLE NUTRIENTS

Skin Dry scaly skin Zinc/essential fatty acids
Follicular hyperkeratosis Vitamin A, C
Photosensitive Niacin
Poor wound healing
Scrotal dermatitis
Hairs Thin/depigmented Protein
Zinc
Eyes Night blindness Vitamin A
keratomalacia Riboflavin

Mouth Bleeding gums Vitamin C

Glossitis Riboflavin
Tongue Color change Vitamin B
Teeth Mottling of enamel Fluorosis
Nails Spoon shaped Iron
Zinc
Copper
Gums Spongy, bleed easily Vitamin C
Lips cheilosis Vitamin B

Muscles Wasting Protein

Energy
Zinc
Bones Enlargement, beading of ribs Vitamin D
Abdomen Diarrhea Niacin
Folate

Clinical signs and symptoms

Signs Present Absent

Eye
Blurred
Yellow
Spotted
Reddened
Hairs
Rough
Easily plucked
De colorized
Split ends
Smooth
Ear
Blocked
Damage lining
Mildly dumb
Skin
Dry
Photo sensitive
Poor wound healing
Dermatitis
Nails
Transverse
Depigmentation
Spooned
Mouth
Bleeding gums
Glossitis
Hypotension
Neck
Thyroid enlargement
Parotid enlargement
Teeth
Ulcer
Bleeding gums
Pain
Sensitivity
Tongue
Color
Texture
Pain
Taste problem
Movement problem
Bones
Bone tenderness
Joint pain
Muscles wasting
Muscles tenderness
Cramping
 Dietary Assessment
Balanced diet
A nutritionally balanced diet fulfils all nutritional needs of the body. Each body need a

specific amount of nutrients and calories to stay active and healthy.

A balanced diet generally contains food from each of the following food groups:

• Starchy foods such as bread, rice, potatoes, pasta, etc.

• Fruit and vegetables.

• Milk and dairy foods.

• Protein foods. These include meat, fish, eggs and other non-dairy sources of protein

Food Pyramid Table

Micronutrients
Micronutrients are vitamins and minerals needed by the body in very small amounts.

However, their impact on a body's health is critical, and deficiency in any of them can cause

severe and even life-threatening conditions.

Macronutrients
The acceptable macronutrient distribution ranges (AMDR) are 45–65% of your daily

calories from carbs, 20–35% from fats and 10–35% from protein. To lose weight, find a ratio you

can stick with, focus on healthy foods and eat fewer calories than you burn.
Dietary Assessment

Dietary assessment involves the collection of information on food and drink consumed

over a specified time that is coded and processed to compute intakes of energy, nutrients and other

dietary constituents using food composition tables.

Dietary Assessment Method

Dietary assessment method is broadly grouped as indirect and indirect method juices may

case symptoms foods than may help are dry salty foods like crackers. Spicy foods with orders

should be avoided.

Diarrhea

Diarrhea is loose, watery stools three or more times a day. Diarrhea may be acute,

persistent, or chronic. Acute diarrhea occurs when the condition lasts for 1 to 2 days. You might

experience diarrhea due to a viral or bacterial infection you acquired via something you ate or

drank.

Nutritional management of diarrhea

Correcting the underlying medical condition dissolve is the first step in treating diarrhea.

When you have diarrhea, eat some foods high in potassium, such as ripe bananas, apricot or peach

nectar, potatoes, fish and meat. Drink fluids between meals. Eat small amounts of food frequently.

Fatty foods such as fried foods, sauces, gravies and salad dressings and highly spiced foods may

not be well tolerated.

Constipation
A condition in which stool becomes hard, dry, and difficult to pass, and bowel movements

don't happen very often. Other symptoms may include painful bowel movements, and feeling

bloated, uncomfortable, and sluggish.

Nutritional management of constipation

Changing your diet and increasing your physical activity level are the easiest and fastest

ways to treat and prevent constipation. Every day, drink 1.5 to 2 quarts of unsweetened fluids, like

water, to hydrate the body. Limit consumption of alcohol and caffeinated drinks, which cause

dehydration. Add fiber -rich foods to your diet, such as raw fruits and vegetables, whole grains,

beans, prunes, or bran cereal. Your daily intake of fiber should be between 20 and 35 grams.

Indirect method – use secondary data such as population-based statistics on food supply

availability and consumption (e.g. food balance sheets or household surveys)

Direct method -– either retrospective or prospective, use individual-based information to assess

the food intake on a personal level e.g. dietary history, screen)

On the personal level, assessing dietary intake can help understand eating habits, track

down eating patterns and map out areas for improvement. There are a few simple tools that could

help record, estimate and monitor food in fiber

Hypertensions
High blood pressure, also called hypertension, is blood pressure that is higher than

normal. Your blood pressure changes throughout the day based on your activities. Having blood

pressure measures consistently above normal may result in a diagnosis of high blood pressure (or

hypertension).

Nutritional management of hypertension

Changing your lifestyle can help control and manage high blood pressure. Your doctor

may recommend that you make lifestyle changes including: Eating a heart-healthy diet with less

salt. Getting regular physical activity. Maintaining a healthy weight or losing weight if you're

overweight or obese. Limiting the amount of alcohol, you drink. But sometimes lifestyle changes

aren't enough. If diet and exercise don't help, your doctor may recommend medication to lower

your blood pressure.

Hepatitis
Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients,

filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be

affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause

hepatitis.

Nutritional management of hepatitis.

Hepatitis A treatment usually focuses on keeping comfortable and controlling signs and

symptoms. You may need to rest. Many people with hepatitis A infection feel tired and sick and

have less energy.

 Manage nausea. Nausea can make it difficult to eat. Try snacking throughout the day

rather than eating full meals. To get enough calories, eat more high-calorie foods. For instance,

drink fruit juice or milk rather than water. Drinking plenty of fluids is important to prevent

dehydration if vomiting occurs.

24 Hours Dietary Recall

Meals or snacks Food items Quantity

Breakfast
Middy
Lunch
Snack
Dinner

Food Record
Food intake Day 1 Day 2 Day 3
Breakfast
Middy
Lunch
Snack
Dinner
24 Hours Dietary Recall
Meals or snacks Food items Quantity
Breakfast
Middy
Lunch
Snack
Dinner

Food Record
Food intake Day 1 Day 2 Day 3
Breakfast
Middy
Lunch
Snack
Dinner
24 Hours Dietary Recall
Meals or snacks Food items Quantity
Breakfast
Middy
Lunch
Snack
Dinner

Food Record
Food intake Day 1 Day 2 Day 3
Breakfast
Middy
Lunch
Snack
Dinner
24 Hours Dietary Recall
Meals or snacks Food items Quantity
Breakfast
Middy
Lunch
Snack
Dinner

Food Record
Food intake Day 1 Day 2 Day 3
Breakfast
Middy
Lunch
Snack
Dinner
24 Hours Dietary Recall
Meals or snacks Food items Quantity
Breakfast
Middy
Lunch
Snack
Dinner

Food Record
Food intake Day 1 Day 2 Day 3
Breakfast
Middy
Lunch
Snack
Dinner
 Dietary Assessment Form

Nausea
• Yes
• No

Vomiting
• Yes
• No

Constipation
• Yes
• No

Diarrhea
• Yes
• No
 Dietary Assessment Form

Nausea
• Yes
• No

Vomiting
• Yes
• No

Constipation
• Yes
• No

Diarrhea
• Yes
• No
 Dietary Assessment Form

Nausea
• Yes
• No

Vomiting
• Yes
• No

Constipation
• Yes
• No

Diarrhea
• Yes
• No
 Dietary Assessment Form

Nausea
• Yes
• No

Vomiting
• Yes
• No

Constipation
• Yes
• No

Diarrhea
• Yes
• No
 Dietary Assessment Form

Nausea
• Yes
• No

Vomiting
• Yes
• No

Constipation
• Yes
• No

Diarrhea
• Yes
• No
 Malnutrition Universal Screening Tool

Step 1

Body Mass index (BMI) (Weight in kg) (height in m)

>20(>30 obese) = 0

18.5 – 20 = 0

<18.5 = 2

Step 2

Unplanned weight loss in past 3-6 months

<5% = 0

5-10% = 1

Step 3

If patient is actually ill and there has been or is likely to be no nutritional intake for >5

days

Score = 2

Step 4

Add scores together to calculate overall risk of malnutrition

Score 0 = low risk

Score 1 = medium risk

Score 2 or more=high risk

 Malnutrition Universal Screening Tool

Name:

____________

Age:

____________

Step 1

BMI = ____________

Score= ___________

Step 2

Unplanned weight loss in 2-6 months

Score = ___________

Step 3

Nutritional intake effected due to illness

Score = __________

Step 4

Added scores to calculate overall risk of malnutrition

Total score = _______

• Low risk = _______

 Malnutrition Universal Screening Tool

Name:

____________

Age:

____________

Step 1

BMI = ____________

Score= ___________

Step 2

Unplanned weight loss in 2-6 months

Score = ___________

Step 3

Nutritional intake effected due to illness

Score = __________

Step 4

Added scores to calculate overall risk of malnutrition

Total score = _______

• Low risk = ________

• Medium risk= ______

• High risk= _____

 Malnutrition Universal Screening Tool
Name:

____________

Age:

____________

Step 1

BMI = ____________

Score= ___________

Step 2

Unplanned weight loss in 2-6 months

Score = ___________

Step 3

Nutritional intake effected due to illness

Score = __________

Step 4

Added scores to calculate overall risk of malnutrition

Total score = _______

• Low risk = ________

• Medium risk= ______

 • High risk= _________

Malnutrition Universal Screening Tool

Name:

____________

Age:

____________

Step 1

BMI = ____________

Score= ___________

Step 2

Unplanned weight loss in 2-6 months

Score = ___________

Step 3

Nutritional intake effected due to illness

Score = __________

Step 4

Added scores to calculate overall risk of malnutrition

Total score = _______

• Low risk = ________

• Medium risk= ______

• High risk= _______

 Malnutrition Universal Screening Tool
Name:

____________

Age:

____________

Step 1

BMI = ____________

Score= ___________

Step 2

Unplanned weight loss in 2-6 months

Score = ___________

Step 3

Nutritional intake effected due to illness

Score = __________

Step 4

Added scores to calculate overall risk of malnutrition

Total score = _______

• Low risk = ________

• Medium risk= ______

• High risk= _______

 Nutritional counselling
Name: Maham sadique
Age:20

Maham is a normal weight teenage girl, so that she needs calories in her diet. She needs to add

carbs in her diet, that is by adding more fruits, vegetables, whole grains, and fat-free or low-fat

milk and milk products. Includes a variety of protein foods such as seafood, lean meats and

poultry, eggs, legumes (beans and peas), soy products, nuts, and seeds. Is low in added sugars,

sodium, saturated fats, trans fats, and cholesterol. Avoid processed or packaged foods. Avoid

foods rich in saturated and trans fats. Emphasizes fruits, vegetables, whole grains, and fat-free or

low-fat milk and milk products. Includes a variety of protein foods such as seafood, lean meats

and poultry, eggs, legumes (beans and peas), soy products, nuts, and seeds.

Is low in added sugars, sodium, saturated fats, trans fats, and cholesterol.

Stays within your daily calorie needs.

‫ اس لیے اسے اپنی خوراک میں کیلوریز کی ضرورت ہے۔ اسے اپنی خوراک میں‬،‫ماہم ایک نارمل نوجوان لڑکی ہے‬

‫ اور چکنائی سے پاک یا کم چکنائی‬،‫ سارا اناج‬،‫ سبزیاں‬،‫ یعنی زیادہ پھل‬،‫کاربوہائیڈریٹ شامل کرنے کی ضرورت ہے‬

‫ دبلے پتلے گوشت‬،‫واال دودھ اور دودھ کی مصنوعات شامل کرکے۔ مختلف قسم کے پروٹین کھانے جیسے سمندری غذا‬

‫ سوڈیم‬،‫ گری دار میوے اور بیج شامل ہیں۔ شامل شکر‬،‫ سویا کی مصنوعات‬،) ‫ پھلیاں (مٹر اور پھلیاں‬،‫ انڈے‬،‫اور پولٹری‬،

‫پروسیس شدہ یا پیک شدہ کھانے سے پرہیز کریں۔ سیر شدہ‬. ‫ اور کولیسٹرول میں کم ہے‬،‫ ٹرانس چربی‬،‫سنترپت چربی‬

‫ اور چکنائی سے پاک یا کم چکنائی‬،‫ سارا اناج‬،‫ سبزیوں‬،‫اور ٹرانس فیٹس سے بھرپور غذاؤں سے پرہیز کریں۔ پھلوں‬

‫والے دودھ اور دودھ کی مصنوعات پر زور دیتا ہے۔ اس میں مختلف قسم کے پروٹین کھانے شامل ہیں جیسے سمندری‬

‫ اور بیج‬،‫ گری دار میوے‬،‫ سویا کی مصنوعات‬،) ‫ پھلیاں (پھلیاں اور مٹر‬،‫ انڈے‬،‫ دبلے پتلے گوشت اور مرغی‬،‫غذا‬.
‫شامل شکر‪ ،‬سوڈیم‪ ،‬سنترپت چربی‪ ،‬ٹرانس چربی‪ ،‬اور کولیسٹرول میں کم آپ کی روزانہ کیلوری کی ضروریات کے اندر‬
‫رہتا ہے۔‬
 Nutritional counselling
Name: Riaz Ali
Age:50

Riaz is an age of 50 years. His weight is 90 Kg & His height is 5.10. His BMI ratio is

generally obese. He needs to decrease his calories & maintain a balance lifestyle. Eat

homemade healthy food. Eat more fruits n vegetables daily. start making healthy choices

makes him to get best health and shape as a bonus. It’s necessary to follow a healthy

lifestyle as fat loss is a gradual process. Following a healthy diet which has optimal

amounts of first-class proteins reduced carbohydrates & healthy fats Limit non-nutritious

foods. Cut down on high-fat foods by: Choosing poultry, fish or lean red meat. Choosing

low-fat cooking methods. Using low-fat or non-fat dairy products. Using, herbs, lemon

or fat-free salad dressings exercise program that is balanced with weight training and

cardio will surely help. Stay consistent & patient in order to achieve weight loss goal.

‫ ہے۔ اس کا باڈی ماس انڈیکس تناسب‬5.10 ‫ریاض کی عمر پچاس سال ہے۔ اس کا وزن نوے کلوگرام اور قد‬

‫عام طور پر موٹاپا ہے۔ اسے اپنی کیلوریز کو کم کرنے اور متوازن طرز زندگی کو برقرار رکھنے کی‬

‫ضرورت ہے۔ گھر کا صحت بخش کھانا کھائیں۔ ۔ روزانہ زیادہ پھل اور سبزیاں کھائیں ۔صحت مند طرز زندگی‬

‫کی پیروی کرنا ضروری ہے کیونکہ چربی کا نقصان ایک بتدریج عمل ہے۔ ایک صحت مند غذا کے بعد جس‬

‫الکوحل والے‬. ‫میں فرسٹ کالس پروٹینز کم کاربوہائیڈریٹس اور صحت مند چکنائی کی زیادہ سے زیادہ مقدار ہو‬

‫ مچھلی یا دبلے پتلے سرخ گوشت کا انتخاب کرنا کم‬،‫پولٹری‬: ‫مشروبات زیادہ چکنائی والے کھانے کو کم کری‬

‫ چکنائی والی یا غیر چکنائی والی دودھ کی مصنوعات‬،‫چکنائی والے کھانا پکانے کے طریقوں کا انتخاب کرنا‬

‫کا استعمال‬
 Nutritional counselling

Name: Rehana Asghar

Age:45

Rehana is a 45 years lady, her weight is 80 & her BMI rate is overweight. She needs to

choose minimally processed, whole foods-whole grains, vegetables, fruits, nuts, healthful

sources of protein (fish, poultry, beans), and plant oils. Limit sugared beverages, refined

grains, potatoes, red and processed meats, and other highly processed foods, such as fast

food. Like refined grains and potatoes, sugary beverages are high in rapidly-digested

carbohydrate. Drink water or other beverages that are naturally calorie-free.

Limit these foods and drinks: Sugar-sweetened beverages

Fruit juice; Refined grains (white bread, white rice, white pasta) and sweets

Potatoes and processed meats. Other highly processed foods, such as fast food.

‫ اس کا وزن اسی کلو گرام ہے اور اس کا باڈی ماس انڈیکس کی شرح‬،‫ریحانہ ایک پنتالیس سال کی خاتون ہے‬

‫ سبزیاں‬،‫ سارا اناج‬- ‫ پوری غذائیں منتخب کرنے کی ضرورت ہے‬،‫زیادہ ہے۔ اسے کم سے کم پروسیس شدہ‬،

‫ پھلیاں )اور پودوں کے تیل۔ چینی والے‬،‫ مرغی‬،‫ پروٹین کے صحت مند ذرائع (مچھلی‬،‫ گری دار میوے‬،‫پھل‬

‫ جیسے فاسٹ‬،‫ اور دیگر انتہائی پراسیس شدہ غذائیں‬،‫ سرخ اور پراسیس شدہ گوشت‬،‫ آلو‬،‫ بہتر اناج‬،‫مشروبات‬

‫فوڈ۔ بہتر اناج اور آلو کی طرح میٹھے مشروبات میں تیزی سے ہضم ہونے والے کاربوہائیڈریٹ کی مقدار زیادہ‬

‫ہوتی ہے۔ پانی یا دیگر مشروبات جو قدرتی طور پر کیلوری سے پاک ہوں۔‬
‫ کھیلوں کے‬،‫ پھلوں کے مشروبات‬،‫چینی سے میٹھے مشروبات (سوڈا‬: ‫ان کھانے اور مشروبات کو محدود کریں‬

‫ سفید پاستا )اور مٹھائیاں؛آلو ؛سرخ گوشت اور‬،‫ سفید چاول‬،‫مشروبات )پھلوں کا رس بہتر اناج (سفید روٹی‬

‫ جیسے فاسٹ فوڈ۔‬،‫پروسس شدہ گوشت۔دیگر انتہائی پروسیس شدہ کھانے‬

Nutritional counselling

Name: Narmeen Asghar

Age:65
Narmeen is a 65 years old lady; her weight is 85 & her BMI rate is overweight. That's

why she needs to decrease calories to be in a state of healthy weight. Eating a variety of

foods from all food groups can help supply the nutrients a person needs as this age. A

healthy eating plan emphasizes fruit, vegetables, whole grains and low-fat or fat-free

dairy; includes lean meat, poultry, fish, beans, eggs and nuts. Eat fruits and vegetables.

They can be fresh, frozen or canned. Eat more dark green vegetables such as leafy greens

like collard greens or mustard greens or broccoli, and orange vegetables such as carrots,

pumpkin, butternut squash and sweet potatoes. Eat whole-grain cereals, breads, crackers,

rice. Have low-fat or fat-free dairy (milk, yogurt or cheese) that are fortified with vitamin

D to help keep your bones healthy. Add Physical Activity.

‫ اس کا وزن پچاسی ہے اور اس کا باڈی ماس انڈیکس کی شرح زیادہ ہے۔ اس لیے اسے‬،‫سال کی خاتون ہے‬

‫صحت مند وزن کی حالت میں رہنے کے لیے کیلوریز کو کم کرنے کی ضرورت ہے۔ تمام فوڈ گروپس سے‬

‫مختلف قسم کے کھانے کھانے سے ان غذائی اجزاء کی فراہمی میں مدد مل سکتی ہے جن کی اس عمر میں‬

‫ سارا اناج اور کم چکنائی یا‬،‫ سبزیوں‬،‫کسی شخص کو ضرورت ہوتی ہے۔ صحت مند کھانے کا منصوبہ پھلوں‬

‫ انڈے اور گری دار میوے شامل‬،‫ پھلیاں‬،‫ مچھلی‬،‫ مرغی‬،‫چکنائی سے پاک ڈیری پر زور دیتا ہے۔ دبال گوشت‬
 ‫ہیں۔ پھل اور سبزیاں کھائیں۔ وہ تازہ‪ ،‬منجمد یا ڈبے میں بند ہو سکتے ہیں۔ زیادہ گہرے سبز سبزیاں کھائیں‬

‫جیسے پتوں والی سبزیاں جیسے کوالرڈ گرینز یا سرسوں کا ساگ یا بروکولی‪ ،‬اور نارنجی سبزیاں جیسے گا‬

‫کم چکنائی والی یا دودھ‪ ،‬دہی یا پنیر )کا استعمال کریں جو آپ کی ہڈیوں کو صحت مند رکھنے میں مدد کے لیے‬

‫وٹامن ڈی سے مضبوط ہوں۔‬

‫‪Nutritional counselling‬‬

‫‪Name: Bakhtawar Khalid‬‬

‫‪Age:10‬‬

‫‪Bakhtawar is an underweight child.so that She need more calories in her diet. We create a weight‬‬

‫‪gain meal plan for underweight, easily followed. We try to add food with high-calorie foods for‬‬

‫‪underweight adults. This diet meal plan is used to provide the right nutrients, vitamins, and‬‬

‫‪minerals required by the body. which are rich in nutrients, it could be snacks, shakes or juices, or‬‬

‫‪proper meals. Eggs and bananas add in breakfast. Whole-wheat bread and pasta; mashed, baked‬‬

‫‪or oven-roasted potatoes; sweet potatoes; corn; and hot cereal are excellent carbohydrate choices.‬‬

‫بختاور ایک کم وزن بچہ ہے اس لیے اسے اپنی خوراک میں زیادہ کیلوریز کی ضرورت ہے۔ ہم کم وزن کے لیے وزن‬

‫بڑھانے کے لیے کھانے کا منصوبہ بناتے ہیں‪ ،‬جس پر آسانی سے عمل کیا جاتا ہے۔ ہم کوشش کرتے ہیں کہ کم وزن‬

‫والے بالغوں کے لیے زیادہ کیلوریز والے کھانے شامل کریں۔ یہ غذا کھانے کا منصوبہ جسم کو درکار صحیح غذائی‬

‫اجزاء‪ ،‬وٹامنز اور معدنیات فراہم کرنے کے لیے استعمال کیا جاتا ہے۔ جو غذائی اجزاء سے بھرپور ہوتے ہیں‪ ،‬یہ‬

‫اسنیکس‪ ،‬شیک یا جوس‪ ،‬یا مناسب کھانا ہو سکتا ہے۔ ناشتے میں انڈے اور کیلے شامل ہوتے ہیں۔ پوری گندم کی روٹی‬

‫اور پاستا؛ میشڈ‪ ،‬سینکا ہوا یا تندور میں بھنے ہوئے آلو؛ میٹھا آلو؛ مکئی اور گرم سیریل کاربوہائیڈریٹ کے بہترین‬

‫انتخاب ہیں۔‬
Objectives

• To find out the junk food consumption in 2nd year students Govt of Mian Rehmat Ali

Graduate College.

Research questions

• What is junk food consumption of 2nd year students of Mian Rehmat Ali Graduate

College??

Delimitations

• It is limited to the 2nd year students of Mian Rehmat Ali Graduate College.

• It is limited to 20 girls.
Chapter 2

Methodology
Population

Students from 2nd year students of Govt Main Rehmat Ali Graduate College.

Sample size

Sample size is 20.

Research tool

Self constructed KAP questionnaire and used as a research tool. KAP assessment is a

descriptive study that can assess and evaluate a target groups current knowledge and

practice.

Analysis

KAP assessment was done through finding out percentages.

Chapter 3

Analysis and Interpretation

Junk foods are defined as foods that are readily available, usually inexpensive, and having less

nutrient value. These foods contain more calories, more salt, have a higher content of saturated

fat and contain less iron, calcium and dietary fiber. Common junk foods include fast food,

carbonated drinks, chips, desserts, chocolates, etc. (Shankar Singh)

A cross-sectional study was conducted among 20 students of 2nd year, Govt Mian

Rehmat Ali memorial collage. We used a stratified proportionate sampling technique to recruit

the participants. A self-administered questionnaire was used for data collection. Descriptive and

bivariate statistical analysis was performed.

The study found that more than half of the participants (60.30%) consumed junk foods

over the last 30 days, more prevalent among public school participants (65.1%) followed by

participants of private school (56.3%). More than half of the participants consumed salty snacks
(58.7%) followed by sweets (57.5%). The time of consumption was found to be higher together

with friends (83.9%).

Chapter 4

Discussion and conclusion

Junk foods are popular stuff, and consumption is increasing constantly. Traditional foods have

been nearly replaced by food items that can be found in a state of ready to eat, in canned form,

and preserved for a longtime. Such consumption may lead to a high prevalence of obesity,

diabetes mellitus, hypertension, and coronary heart disease Generally junk foods are very

appealing and tasty for people of all age groups, however it is very true that they are very thick

inside.

Junk food is never considered good for health, they have been proven to be unhealthy in

all ways. Junk foods are harmful to health, and people who practice eating junk food have many

health disorders .It can cause heart disease, cancer, early aging, high blood pressure, bone

problems, diabetes, mental disorders, liver disorders, digestive system problems, constipation,
diarrhea, heart attack, prostate and breast cancer, osteoporosis and so many health disorders

.Junk foods have a good taste and are mostly preferred by children of any age group and school

children .Parents never share the ill effects of junk food so they demands for junk food.

Some foods such as French fries, fried foods, pizza, burgers, candy, soft drinks, baked

goods, ice cream, cookies, etc. are examples of high sugar and high fat foods.

It is found according to the Centers for Disease Control and Prevention that children who eat

junk food are at a greater risk of developing type-2 diabetes.

In type-2 diabetes, our body becomes unable to control blood sugar level.

Our study findings reveal an increasing junk food consumption among school going-

adolescents, which may contribute to poor growth outcomes. Consumption during travel time,

restaurants, home, and school were found to be more common. Family and peer roles were also

found to be more influencing for junk food accompanying the participants increased

consumption. Interestingly, media exposure played a promotive role in junk food promotion, and

among these, friend's influence is most influential.

Consumption of junk food among adolescent students was remarkably high in both public

school and private school adolescents. Regardless of adequate knowledge on harmful

consequences of junk foods, school-going adolescents are consuming junk food due to its easy

availability and ready-to-use packaging.

In conclusion, we need a healthy lifestyle to build up a healthy immune system and to

avoid disease. Here, “maintain” means a healthy immune system to protect your body. To

maintain body immunity. We mentioned 3-features-method before First is nutrients. We should

eat a variety of food and keep a balanced diet (Prof. Hsieh).

Name: _____________

Roll num: ______________

Approved By: ____________

Remarks: ______________
 Must Tool

Nutritional Assessment

Anthropometric Assessment

Biochemical Assessment

Clinical Assessment

Dietary Assessment

KAP Study junk food consumption among 2nd year

students of Govt Mian Rehmat Ali Graduate Collage

Pre-testing

Presentation and Lecture

Post-testing

Analysis of pre-test

Analysis of pro-test