Anthropometric Nutritional Assessment - An Overview

Introduction

One can assess body size and body composition by using anthropometric measurements. These measurements cannot detect a specific nutrient, short-term disturbances, or deficiency, but they are non-invasive, simple, and safe methods. To Interpret and group the anthropometric data, two or more raw measurements are derived from anthropometric indices. Based on the consideration of the specificity, sensitivity, predictive value, and any potential modifying factors are used to select indices. Body-mass index, waist-hip circumference ratio, and weight for height are a few examples that are included in it. Comparing with predetermined reference limits or cut-off points is always evaluated using anthropometric indices.

In anthropometry, there are three major sources of error:

• In certain tissues, there is a change in composition and physical properties.

• Errors in measurements.

• Invalid assumptions are used to derive a body composition from the measurements.

How Is Nutritional Assessment Very Important to the Individual?

Nutritional assessment includes collecting information about the client's medical history, dietary practices, food security situation, and current treatment through anthropometric measurements.

• The overall body weight and condition for each nutrient in the state of the body are defined as an optimal nutrition status.

• This nutritional status is vital in promoting health by preventing and treating diseases.

• One can control the prolonged hospitalization in individuals who lost 10 percent or more weight, and death can also be controlled in individuals who are lean and healthy and lose weight by more than 35 percent.

• The nutritional status affects the response to medical therapies and the immune response.

Healthcare providers give many reasons to assess the individual for nutritional status. Some of them are:

• People at risk of malnutrition at an early period or referral, before they become malnourished should be identified.

• Malnourished patients for treatment should be identified first because they have higher morbidity and mortality rate.

• Those not treated early have a slower recovery rate from infections and complications and more extended hospital stays.

• One should regularly track the child's growth.

• Medical complications which affect the body’s ability to digest food and nutrient utilization should be identified.

• Practices that can increase the risk of malnutrition and infection should be detected.

• Counseling and nutrition education should be informed so that it helps to develop the appropriate nutrition care plans.

• One can achieve nutrition assessment, counseling, and support for an individual with the result of the classification of nutritional status and the client's nutrition assessment.

How Is Nutrition Screening Done on Individuals?

• Before a complete nutrition assessment starts, a simple and rapid identification of malnourished or people at risk of malnutrition needs a more detailed nutrition assessment.

• Nutritionists and trained facility-based or community service providers can screen nutrition in healthcare facilities during growth monitoring or home-based care and support group meetings.

• Through simple nutrition screening, people can check the bilateral swelling, weight measurement, and mid-upper arm circumference. And it also includes asking about recent illness and appetite.

• With the help of national and local health policy, nutrition screening requires standardized training.

• For low literacy and illiterate population, special training materials are needed.

• Government-approved recording, clear guidance on provider rules, and referral materials to whom, how, and how often one should screen the people are required for community service providers.

• Healthcare providers need incentives to do accurate and consistent community nutrition screening and make referrals.

How Many Times Should Nutrition Assessment Be Done on Individuals?

• Based on the client's age and other factors such as pregnancy, disease status, and national policies, the frequency of nutritional assessment is done.

• Based on the national guidelines, given below are a few adjusted recommendations:

Postpartum or Pregnant Women:

A nutritional assessment is done on every antenatal visit.

0 to 6 Months Age Infants:

A nutritional assessment is done at birth and on every scheduled postnatal visit.

6 to 59 Months Age Infants:

A monitoring session is done during the monthly growth for children under two and older every three months.

Five Years Old Children and Above Age Group:

One should do a nutrition assessment on every clinic visit.

Adults and Adolescents Age Group:

One should do a nutrition assessment on every clinic visit.

HIV (Human Immunodeficiency Virus) People:

Nutritional assessment is done every clinic visit and when initiating or changing the antiretroviral therapy (ART).

How Is Anthropometric Assessment Done on Individuals?

• The body measurement's size, weight, and proportions are known as anthropometry.

• Height, weight, MUAC (mid-upper arm circumference), head circumference, and skin fold are the common anthropometric measurements included in them.

• Anthropometric measurements, like body-mass index and height for weight, are presented as indexes.

• Z - score is the name given to record each of these indexes. And these Z scores are measured in standard deviations.

• It helps to describe how far and in which direction an individual anthropometric measurement deviates from the measurement of the same age and sex of a healthy person.

Given below are some anthropometric assessment indexes:

Weight:

• The first step in anthropometric assessment is usually weight. And it is a prerequisite for finding weight for height Z- score for children and BMI (body mass index) for adults.

• Health status is strongly related to the weight of an individual.

• Poor health and the ability to fight infection are reduced in people with unintentional weight loss.

• Errors can lead to incorrect nutritional status classification and unfair treatment. So accurate weight measurement is important.

Length and Height:

• A height board or measuring tape marked in centimeters (cm) is required to measure length and height.

• One should measure the length for children under two years of age or less than 87 cm long. and

• Height is measured for children two years and older who are more than 87 cm tall.

Weight for Height:

• The nutritional status of children is assessed from birth to 59 months of age using a weight-for-height index (WHZ).

• According to WHO (World Health Organization) child growth standards, a child’s nutrition status can be classified by comparing the child’s weight to that of a child of the same length/height and sex.

• For boys and girls, there are separate WHO child’s growth standards.

• WHZ can be automatically calculated using tools like The Standardised Monitoring And Assessment of Relief and Transition (SMART), an Emergency Nutrition Assessment tool available on the NutriSurvey website.

• An online SMART training package is also available.

MUAC:

• It is defined as the circumference of the left upper arm measured using a MUAC tape at the midpoint between the tip of the shoulder and the tip of the elbow.

• Millimeter measurements in MUAC are more accurate than centimeter measurements.

• For infants under six months and people having edema is currently not recommended and is supposed to be measured with MUAC.

• To measure the children's (instead of WHZ), and in adolescents (instead of BMI), non-pregnant or postpartum adults, and people whose height and weight cannot be measured, this MUAC index is the appropriate alternative.

Body-Mass Index (BMI):

• It is an anthropometric indicator based on the weight-to-height ratio.

• In non-pregnant/non-postpartum adults, BMI is used to classify malnutrition.

• But in pregnant women and people with edema, it is not an accurate indicator of nutritional status.

• Body mass index is calculated by dividing the person’s weight in kg by the square of the person’s height in meters. Then measurements are converted from centimeters to meters. Using look-up tables or a BMI wheel, body mass index is determined.

Conclusion

One needs a proper and accurate identification to understand the severity to address an issue. Nutrition on health, development, and economic productivity shows adverse effects. BMI and MUAC do not show more accurate results on nutrition status than the newly computed composite score. One can lower the probability of misclassification, and the newly added composite score will give population-based cut-off valves. Based on the data of other population groups, it is expected that scientific ventures will continue to develop these scores and will help to know this new method effortlessly.