To critically evaluate clinical methods used for assessing an element of an individuals nutritional status.
Answers
Nutritional assessment can be defined as the interpretation from dietary, laboratory, anthropometric, and clinical studies. It is used to determine the nutritional status of individual or population groups as influenced by the intake and utilization of nutrients” (Gibson, 2005). Nutritional status represents meeting of human body needs for nutritive and protective substances and the reflection of these in physical, physiological, and biochemical characteristics, functional capability, and health status. Information about nutritional status, i.e., nutritional assessments, is essential for identification of potential critical nutrients (at population groups at risk of deficiency); formulation of recommendations for nutrient intake; development of effective public health nutrition (PHN) program for nutrition-related diseases prevention; and monitoring the efficiency of such interventions (Elmadfa and Meyer, 2014). In current nutrition epidemiology (NE) and PHN research, data collection and comparison against each other, and recommendations, and further development and application of a harmonized and standardized nutritional assessment methodology is a necessity (Gurinović, 2016). Beside these major instruments, to correctly interpret the results of nutritional assessment methods, other factors (socioeconomic status, cultural practices, and health and vital statistics–ecological factors) should also be considered.
This article elaborates dietary, biochemical, and anthropometric measurements as nutritional assessment methods that can be applied in four forms of nutritional assessment system: surveys, surveillance, screening, or interventions.
Nutrition Surveys are usually national cross-sectional studies that are performed to assess the nutritional status of a selected population, identify the group at risk of chronic malnutrition, evaluate existing nutritional problems, and inform evidence-based nutrition policies. Another application of nutrition surveys is to evaluate the efficacy of an intervention using data from baseline and final assessments (Gibson, 2005).
Nutritional surveillance—Public health surveillance is the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice (WHO, 2017). Data in nutritional surveillance studies are collected, analyzed, and evaluated in a standardized manner during a longer period of time. They can be used for the identification of possible nutritive risk factors of malnutrition of a whole population or specific vulnerable group. Formulation, evaluation, and monitoring of the nutrition intervention programs and policies are main objectives of nutrition surveillance (Gibson, 2005).
Nutrition screening is used to identify malnourished individuals. It can be carried out on the whole population, on specific subpopulations at risk or on selected individuals (Gibson, 2005). During nutritional screening, simple, cheap, and rapid measurement methods are used.
Nutrition interventions are carried out on population subgroups at risk, which are identified during nutrition surveys or screening. Supplementation and fortification are some examples of nutrition interventions. Providers require efficient monitoring and evaluation to prove the efficiency and soundness of these interventions. There are three types of evaluation designs. In the simplest one, the whole targeted group is exposed to the intervention, and the outcome is measured against previously defined goals—“adequacy evaluation.” The second—“plausibility evaluation” requires quasiexperimental conditions, where one group receives an intervention while the othercontrol group does not, or receives a “placebo.” In this design, the subjects are not randomized,