DIETARY ASSESSMENT AND DIET

CALCULATION

Dr. Vineet Lakhanpal

Dr. Saurabh Rattan

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Nutrition

Science of food and it’s relationship to health.

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 BALANCED DIET
 Contains variety of food

 In quantities that need of all macro and micronutrients is

adequately met.

 For maintaining health, vitality and general wellbeing.

 Also makes a small provision for extra nutrients to withstand

short duration of leanness.

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Recommended Dietary allowance

 Average daily dietary nutrient intake level , sufficient

to meet the daily requirement, of 97-98% (97.5%) of
healthy individuals of a particular age group and
gender.

 Not used for energy. (Calorie)

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Indian Reference Male

 Age: 18-29 yrs • Disease free

 Wt : 60 Kg • Physically fit for active work

• 8 hrs of moderate activity

 Ht : 1.73 mtrs.
•8 hrs in bed & 2 hrs walking
 BMI: 20.3
•4-6 in sitting & moving around

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Indian Reference Female

 Age: 18-29 yrs • Disease free, on pregnant, non

lactating
 Wt : 55 Kg
• Physically fit for active work

 Ht : 1.61 mtrs. • 8 hrs of moderate activity

 BMI: 21.2 •8 hrs in bed & 2 hrs walking

•4-6 in sitting & moving around

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Concept of Consumption Unit

 Family constitutes of members of different

age, gender and working class

 Male sedentary worker is considered as

standard. (CU=1)

 Requirement of other members is calculated

as compared to 1 CU

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 Methods of Dietary Survey
1. Weightment of Raw Food: Before cooking

2. Weightment of cooked food: Hostels

3. Food frequency questionnaire method: community

4. Food Balance sheet method: National level

5. 24 hour recall method: Family

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 24 hour recall method
 Ask family member to recall all the food
consumed by family in the last 24 hours.

 Start from the most recent meal and continue up

to previous day .(12 PM to 12 PM).

 Amount of each raw ingredient.

 Normally for 7 days but in posting 3 days.

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1. Find out fortnightly/monthly consumption for items
procured fortnightly/monthly e.g. rice, wheat, pulses, oil
etc. and calculate average daily consumption.

2. Find out weekly consumption for items such as fish,

meat, eggs, fruits etc. and calculate average daily
consumption.

3. Find out daily consumption of regularly used items such

as milk, vegetables etc.

4. Find out consumption of any occasionally used items

during last 24 hours e.g. chocolates, biscuits, sweets, ice-
cream etc.
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5. Take into account if any member has not taken
meal during the 24 hrs. period of taking history.

6. Deduct the consumption of food by guests, if any.

7. Don’t take the diet consumed on the occasion of

fast, feast and festival.

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For index case

 Cooked food preparation.

 Only calorie calculation.

 For HTN case calculate salt consumption also.

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 Assessment of nutritional
status
 Multi angled approach, with various
techniques including
 Clinical Examination
 Anthropometry
 Biochemical evaluation
 Functional assessment
 Assessment of dietary intake
 Vital and health statistics
 Ecological studies

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 Clinical Examination
 To assess level of health of individuals or
population in relation to food consumption.
 Physical signs are associated with states of
malnutrition(specific/non-specific).
 Two or more signs present simultaneously
enhance the diagnostic significance.
 However can not quantify malnutrition based
on clinical signs, many are not accompanied
with physical signs or less specific.

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 Angular stomatitis: Vitamin B2
 Bitot’s Spots: Vitamin A
 Calf Tenderness: Vitamin B12(P. Neuropathy)
 Beri Beri : Vitamin B1
 Enlargement of Thyroid Gland: Iodine Deficiency

Standard survey forms have been devised covering

all areas of body.

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 Nutritional assessment
schedule
1. General appearance: Normal / Thin
2. Hair : N / Lack of lustre /Flag sign/ Thin sparse
3. Face : Depigmentation/ Moon face
4. Eyes : Bitot’s Spot / Dry conjuctiva/opaque cornea
5. Lips : N / Angular stomatitis
6. Tongue : N/Pale & flabby/ fissured
7. Skin : N/Dry scaly/ hyperkeratosis/ petechiae
8. Nails : Koilonychia

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 Anthropometry

 Ht
 Wt
 Skinfold thickness
 Arm cirumference
 Recorded over a period of time, reflect
pattern of growth & development.
 By this we calculate deviation from average
at various ages.

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Lab & Biochemical assessment
 Lab - Hb status ,stool & urine examination

 Bio chemical – used to assess the levels of

nutrient concentration in body fluids, levels of
enzymes, levels of electrolytes.
 Used to quantify the deficiency
 Time consuming & expensive
 Eg .Vitamin K level –Prothrombin Time

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 Functional Indicator
 Any deficiency causing functional impairment.
 Capillary fragility : Vit C
 Erythrocyte fragility : Vit. E ,Se
 Prothrombin Time : Vit K
 Sperm count : Zn
 Nerve conduction : Vit B1,B12

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Assessment of dietary intake
 Weighment of raw food in one dietary cycle
 Weighment of cooked foods
 Oral questannaire method bsaed on
consumption of previous 24-48 hrs about
nature and quantity of food.
 Data is translated into mean
intake(grams.eg.cereals,pulses,fruits,milk,
meat,eggs),consumption unit
 Nutritive value of Indian Foods

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 Vital Stats & Ecological
Factors
 Analysis of vital stats indicates the risk to
community.eg IMR , LBWB
 Study of ecological factors consist the following:
 Food Balance Sheet
 Socio Economic Factor
 Health & Educational Services

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