Book•
Principles of Nutritional Assessment
18 Jan 1990-
TL;DR: Assessment of nutrient intakes from food consumption data and the status of vitamins, A, D, and E, and niacin, and trace element status and nutritional assessment of hospital patients.
Abstract: PART 1: INTRODUCTION PART 2: FOOD CONSUMPTION AT THE NATIONAL AND HOUSEHOLD LEVELS PART 3: MEASURING FOOD CONSUMPTION OF INDIVIDUALS PART 4: ASSESSMENT OF NUTRIENT INTAKES FROM FOOD CONSUMPTION DATA PART 5: MEASUREMENT ERRORS IN DIETARY ASSESSMENT PART 6: REPRODUCIBILITY IN DIETARY ASSESSMENT PART 7: VALIDITY IN DIETARY ASSESSMENT METHODS PART 8: EVALUATION OF NUTRIENT INTAKES AND DIETS PART 9: ANTHROPOMETRIC ASSESSMENT PART 10: ANTHROPOMETRIC ASSESSMENT OF BODY SIZE PART 11: ANTHROPOMETRIC ASSESSMENT OF BODY COMPOSITION PART 12: ANTHROPOMETRIC REFERENCE DATA PART 13: EVALUATION OF ANTHROPOMETRIC INDICES PART 14: LABORATORY ASSESSMENT OF BODY COMPOSITION PART 15: LABORATORY ASSESSMENT PART 16: ASSESSMENT OF PROTEIN STATUS PART 17: ASSESSMENT OF IRON STATUS PART 18: ASSESSMENT OF THE STATUS OF VITAMINS A, D AND E PART 19: ASSESSMENT OF VITAMIN C STATUS PART 20: ASSESSMENT OF THE STATUS OF THIAMIN, RIBOFLAVIN, AND NIACIN PART 21: ASSESSMENT OF VITAMIN B6 STATUS PART 22: ASSESSMENT OF FOLATE AND VITAMIN B12 STATUS PART 23: ASSESSMENT OF CALCIUM, PHOSPHORUS AND MAGNESIUM STATUS PART 24: ASSESSMENT OF CHRONIUM, COPPER AND ZINC STATUS PART 25: ASSESSMENT OF IODINE AND SELENIUM STATUS PART 26: CLINICAL ASSESSMENT PART 27: NUTRITIONAL ASSESSMENT OF HOSPITAL PATIENTS
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TL;DR: The relationships between selenium intake/status and health, or risk of disease, are complex but require elucidation to inform clinical practice, to refine dietary recommendations, and to develop effective public health policies.
Abstract: This review covers current knowledge of selenium in the environment, dietary intakes, metabolism and status, functions in the body, thyroid hormone metabolism, antioxidant defense systems and oxidative metabolism, and the immune system. Selenium toxicity and links between deficiency and Keshan disease and Kashin-Beck disease are described. The relationships between selenium intake/status and various health outcomes, in particular gastrointestinal and prostate cancer, cardiovascular disease, diabetes, and male fertility, are reviewed, and recent developments in genetics of selenoproteins are outlined. The rationale behind current dietary reference intakes of selenium is explained, and examples of differences between countries and/or expert bodies are given. Throughout the review, gaps in knowledge and research requirements are identified. More research is needed to improve our understanding of selenium metabolism and requirements for optimal health. Functions of the majority of the selenoproteins await characterization, the mechanism of absorption has yet to be identified, measures of status need to be developed, and effects of genotype on metabolism require further investigation. The relationships between selenium intake/status and health, or risk of disease, are complex but require elucidation to inform clinical practice, to refine dietary recommendations, and to develop effective public health policies.
1,034 citations
TL;DR: The high prevalence of hypovitaminosis D among African American women warrants further examination of vitamin D recommendations for these women, and the determinants ofHypov vitamin D among women should be considered when these women are advised on dietary intake and supplement use.
990 citations
TL;DR: In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error is critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometrical nutritional status discussed.
Abstract: Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, as is the most commonly used measure of anthropometric measurements error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group or population under investigation R>0.95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.
911 citations
TL;DR: In this paper, the authors evaluated the use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer.
Abstract: Objective: To evaluate the use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Design: An observational study assessing the nutritional status of patients with cancer. Setting: Oncology ward of a private tertiary Australian hospital. Subjects: Seventy-one cancer patients aged 18–92 y. Intervention: Scored PG-SGA questionnaire, comparison of scored PG-SGA with subjective global assessment (SGA), sensitivity, specificity. Results: Some 24% (17) of 71 patients were well nourished, 59% (42) of patients were moderately or suspected of being malnourished and 17% (12) of patients were severely malnourished according to subjective global assessment (SGA). The PG-SGA score had a sensitivity of 98% and a specificity of 82% at predicting SGA classification. There was a significant difference in the median PG-SGA scores for each of the SGA classifications (P<0.001), with the severely malnourished patients having the highest scores. Re-admission within 30 days of discharge was significantly different between SGA groups (P=0.037). The mortality rate within 30 days of discharge was not significantly different between SGA groups (P=0.305). The median length of stay of well nourished patients (SGA A) was significantly lower than that of the malnourished (SGA B+C) patients (P=0.024). Conclusion: The scored PG-SGA is an easy to use nutrition assessment tool that allows quick identification and prioritisation of malnutrition in hospitalised patients with cancer. Sponsors: The Wesley Research Institute.
892 citations
01 Jan 1999
TL;DR: Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision, which should allow increased precision of measurement, and improved interpretation of anthropometric data.
Abstract: Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group or population under investigation. R . 0·95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data. Anthropometry: Nutritional status: Measurement error: Imprecision
884 citations
Cites background or methods from "Principles of Nutritional Assessmen..."
...Operationally, accuracy is determined by comparison of measures made against those of a criterion anthropometrist, an individual who has internalized, as far as is humanly possible, the rules of anthropometric measurement as delineated in the literature (e.g. Cameron et al. 1981; Cameron, 1984, 1986; Lohman et al. 1988; Gibson, 1990; Norton & Olds, 1996) and has received training to the highest level and compares well in anthropometric measurement against another criterion anthropometrist....
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...measurement between trainer and trainee, include evaluation of the technique of the trainee relative to the criterion anthropometrist, and of both trainee and criterion anthropometrist relative to standard techniques given in reference manuals (e.g. Cameron et al. 1981; Cameron, 1984, 1986; Lohman et al. 1988; Gibson, 1990; Norton & Olds, 1996)....
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...Anthropometry has an important place in nutritional assessment (Jelliffe & Jelliffe, 1989; Gibson, 1990), and in addition to use in the clinical setting (Gibson, 1990) is used in nutritional screening, surveillance, and monitoring British Journal of Nutrition (1999), 82, 165–177 165...
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...The literature on methods of anthropometric measurement and interpretation is large (e.g. Weiner & Lourie, 1981; Cameron, 1984, 1986; Heymsfield et al. 1984; Lohman et al. 1988; Jelliffe & Jelliffe, 1989; Gibson, 1990; Ulijaszek & Mascie-Taylor, 1994; World Health Organization, 1995; Norton & Olds, 1996; Ulijaszek, 1997)....
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