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Chapter 072. Malnutrition and Nutritional Assessment (Part 6)

Anthropometrics Anthropometric measurements provide information on body muscle mass and fat reserves. The most practical and commonly used measurements are body weight, height, triceps skinfold (TSF), and mid-arm muscle circumference (MAMC). Body weight is one of the most useful nutritional parameters to follow in patients who are acutely or chronically ill. Unintentional weight loss during illness often reflects loss of lean body mass (muscle and organ tissue), especially if it is rapid and not caused by diuresis. This can be an ominous sign since it indicates use of vital body protein stores as a metabolic fuel. . | Chapter 072. Malnutrition and Nutritional Assessment Part 6 Anthropometries Anthropometric measurements provide information on body muscle mass and fat reserves. The most practical and commonly used measurements are body weight height triceps skinfold TSF and mid-arm muscle circumference MAMC . Body weight is one of the most useful nutritional parameters to follow in patients who are acutely or chronically ill. Unintentional weight loss during illness often reflects loss of lean body mass muscle and organ tissue especially if it is rapid and not caused by diuresis. This can be an ominous sign since it indicates use of vital body protein stores as a metabolic fuel. The reference standard for normal body weight body mass index BMI or weight in kilograms divided by height in meters squared is discussed in Chap 75. BMIs 18.5 are considered underweight 18.5-24.9 are normal 25-29.9 are overweight and 30 are obese. Measurement of skinfold thickness is useful for estimating body fat stores because about 50 of body fat is normally located in the subcutaneous region. Skinfold thicknesses can also permit discrimination of fat mass from muscle mass. The TSF is a convenient site that is generally representative of the body s overall fat level. A thickness of 3 mm suggests virtually complete exhaustion of fat stores. The MAMC often used to estimate skeletal muscle mass is calculated as follows MAMC cm upper arm circumference www.BcitttHoc. Com Laboratory Studies A number of laboratory tests used routinely in clinical medicine can yield valuable information about a patient s nutritional status if a slightly different approach to their interpretation is used. For example abnormally low serum albumin levels total iron-binding capacity and anergy may have a distinct explanation but collectively they may represent kwashiorkor. In the clinical setting of a hypermetabolic acutely ill patient who is edematous and has easily pluckable hair and inadequate protein intake the diagnosis of .