Equipment
Height is measured with a stadiometer (see image below).
Stadiometer. Courtesy of the Scottish Health Survey 2010 - Volume 2: Technical Report published by the Scottish Government, available at http://www.scotland.gov.uk/Publications/2011/09/27124046/0.
Weight is measured with a scale (see image below).
The images below show various tools used for body composition analysis.
Hydrodensitometer. Courtesy of Human Performance Lab, University of Wisconsin-La Crosse.
Monitoring & Follow-up
No long-term monitoring or follow-up is needed after nutritional status assessment in adults. However, serial assessments prove useful in monitoring nutritional status and responses to intervention over time.
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Stadiometer. Courtesy of the Scottish Health Survey 2010 - Volume 2: Technical Report published by the Scottish Government, available at http://www.scotland.gov.uk/Publications/2011/09/27124046/0.
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Tricep skinfold thickness measurement with plastic calipers. Courtesy of the CDC.
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Subscapular skinfold thickness measurement with plastic calipers. Courtesy of the CDC.
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Upper arm length measurement and mid-arm mark. Courtesy of the CDC.
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Scale. Courtesy of Detecto Scale (www.Detecto.com).
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Metal Harpenden calipers. Courtesy of Baty International Ltd.
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Plastic calipers. Courtesy of Wikipedia.
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Hydrodensitometer. Courtesy of Human Performance Lab, University of Wisconsin-La Crosse.
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Air displacement plethysmograph. Courtesy of Wikipedia.
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Fist-grip (hand) dynamometer. Courtesy of Lafayette Instrument Company, Inc.
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BMI graph. Courtesy of Wikipedia.
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Subjective Global Assessment (SGA) form.
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MNA®-Short Form. Courtesy of Nestlé Nutrition Institute (http://www.mna-elderly.com/).
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MNA®-Long Form. Courtesy of Nestlé Nutrition Institute (http://www.mna-elderly.com/).
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DEXA scanner. Courtesy of CDC.
Tables
- Table 1. Symptoms and Signs of Nutritional Deficiency (from the Merck Manual of Diagnosis and Therapy, edited by Robert Porter. Copyright 2012 by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co, Inc, Whitehouse Station, NJ. Available at http://www.merckmanuals.com/professional/. Accessed 11/18/2013)
- Table 2: Standards for Upper Arm Muscle Area in Adults (From the Merck Manual of Diagnosis and Therapy, edited by Robert Porter. Copyright 2012 by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co, Inc, Whitehouse Station, NJ. Available at http://www.merckmanuals.com/professional/. Accessed 11/18/2013).
- Table 3: Serum Proteins Used for Assessment of Nutritional Status [3, 33, 34]
Area/System |
Symptom or Sign |
Deficiency |
General appearance |
Wasting |
Energy |
Skin |
Rash |
Many vitamins, zinc, essential fatty acids |
Rash in sun-exposed areas |
Niacin (pellagra) |
|
Easy bruising |
Vitamin C or K |
|
Hair and nails |
Thinning or loss of hair |
Protein |
Premature whitening of hair |
Selenium |
|
Spooning (upcurling) of nails |
Iron |
|
Eyes |
Impaired night vision |
Vitamin A |
Corneal keratomalacia (corneal drying and clouding) |
Vitamin A |
|
Mouth |
Cheilosis and glossitis |
Riboflavin, niacin, pyridoxine, iron |
Bleeding gums |
Vitamin C, riboflavin |
|
Extremities |
Edema |
Protein |
Neurologic |
Paresthesias or numbness in a stocking-glove distribution |
Thiamin (beriberi) |
Tetany |
Ca, Mg |
|
Cognitive and sensory deficits |
Thiamin, niacin, pyridoxine, vitamin B12 |
|
Dementia |
Thiamin, niacin, vitamin B12 |
|
Musculoskeletal |
Wasting of muscle |
Protein |
Bone deformities (e.g., bowlegs, knocked knees, curved spine) |
Vitamin D, Ca |
|
Bone tenderness |
Vitamin D |
|
Joint pain or swelling |
Vitamin C |
|
GI |
Diarrhea |
Protein, niacin, folate, vitamin B12 |
Diarrhea and dysgeusia |
Zinc |
|
Dysphagia or odynophagia (due to Plummer-Vinson syndrome) |
Iron |
|
Endocrine |
Thyromegaly |
Iodine |
Percentage of Standard (%) |
Men (cm2) |
Women (cm2) |
Muscle Mass |
100 ± 20* |
54 ± 11 |
30 ± 7 |
Adequate |
75 |
40 |
22 |
Marginal |
60 |
32 |
18 |
Depleted |
50 |
27 |
15 |
Wasted |
*Mean mid upper arm muscle mass ± 1 standard deviation. From the National Health and Nutrition Examination Surveys I and II. |
|||
Protein |
Half-life, days |
Function |
Comment |
Albumin |
14-20 |
Maintenance of plasma oncotic pressure; carrier protein |
levels increase with dehydration, blood and albumin transfusion, and anabolic steroids levels decrease in liver failure, inflammation, volume overload states (cirrhosis, congestive heart failure, renal failure), zinc deficiency, protein-losing states (nephrotic syndrome, enteropathy), corticosteroid use, and bedrest |
Transferrin |
8-9 |
Iron transport |
levels increase during dehydration, iron deficiency, pregnancy, estrogen therapy, and acute hepatitis levels decrease in liver and renal failure, inflammation, anemia due to chronic disease and vitamin B12 and folate deficiency, corticosteroids, zinc deficiency, and protein-losing states (nephrotic syndrome, enteropathy) Often measured indirectly as total iron-binding capacity (TIBC) |
Prealbumin (transthyretin) |
2-3 |
Binds thyroxine; carrier for retinol-binding protein |
levels increase in renal failure (degraded by the kidney) and corticosteroid and oral contraceptive use levels decrease in liver failure, inflammation, and hyperthyroidism |
Retinol-binding protein (RBP) |
12-24 |
Vitamin A transport; binds to prealbumin |
levels increase in renal failure (degraded by the kidney) levels decrease in cirrhosis, inflammation, vitamin A and zinc deficiency, and hyperthyroidism |
