NUTRITIONAL

ASSESSMENT BY
ANTHROPOMETRY AND
CLINICAL EXAMINATION
ANAGH SAHA
ROLL NO-7
4TH SEMESTER
KPC MEDICAL COLLEGE & HOSPITAL
INTRODUCTION

The nutritional status of an individual is often the

result of many inter-related factors. It is influenced by
the adequacy of food intake both in terms of quantity
and quality and also by the physical health of the
individual. The nutritional status of a community is
the sum of the nutritional status of the individuals
who form that community.
OBJECTIVES OF NUTRITIONAL
ASSESSMENT

The objectives are :

To obtain precise information on the prevalence and
distribution of nutritional problems of a given family.
Identification of individuals or population groups at risk
or in greatest needs of assistance.
To develop a health care programme that meets the
needs defined by that assessment, including evaluation
of the effectiveness of such programmes.
METHODS OF NUTRITIONAL
ASSESMENT
DIRECT INDIRECT
1.Anthropometry 1.Vital statistics

2.Biochemical 2.Ecological factors

investigation
3.Functional
3.Clinical examination assessment

4.Dietary survey
 OBJECTIVES
• To assess the nutritional status of members of
the allotted family.

• To take anthropometric measurements of the

allotted family members and find out any
deviation from the normal.

• To perform clinical examinations and advise

the family members accordingly.

• To suggest measures for improvements.

 MATERIALS AND METHODOLOGY

Study type: Observational, Descriptive, Cross-sectional

Study period: 3rd February, 2016- 20th February, 2016.

Study area : Simultala, Sonarpur

Study population: 3 members

Study tools: Measuring tape, Camera, Weighing machine, stethoscope,

Sphygmomanometer, Torch, Practical Guide Book..

Study Technique : Data was collected by interviewing the

family members & taking measurements
wherever necessary
 FAMILY CHART

Sr.
No. Name Age Sex Relation Marital Education
with HOF Status
1. Mr. 40 Male H.O.F Married Till class 5
Shamshuddin years
Haldar
2. Mrs. Ayesha 37 Female Wife of H.O. Married Till class 6
Haldar years F

3. Miss Sarika 15 Female Daughter of Unmarrie Class 10

Haldar years H.O.F d (present)
 Name Occupation Nature of Type of income Addiction
work work

Mr.Shamshuddin Contracter Sedentary Unskilled INR500 Chews

Haldar (dalal) 0 tobacco

Mrs. Ayesha House-wife Sedentary Unskilled None None

Haldar

Miss Sarika Haldar Student Sedentary Unskilled None None

SR. NO NAME PRESENT PAST ILLNESS
ILLNESS
1. Mr. Shamshuddin Haldar Nothing RTA- head and
significant. leg injury.
2. Mrs. Ayesha Chest pain, joint Nothing
Haldar pain. significant.
3. Miss Sarika Haldar Nothing Nothing
significant. significant.

Priority Members:
1.Miss Sarika Haldar (adolescent girl)
2.Mrs. Ayesha Haldar (women of reproductive age group)
3. Mr. Shamshuddin Haldar (obese)
  TYPE OF FAMILY- Nuclear Family

Phase of nuclear family- Extension

 HEAD OF FAMILY-Mr. Shamshuddin Haldar

 TOTAL FAMILY MEMBERS- 03

 RELIGION- Hindu

 TOTAL MONTHLY FAMILY INCOME- Rs 5,000/-

 MOTHER TONGUE- Bengali

 SOCIOECONOMIC STATUS
• Socioeconomic status has been defined as the position
that an individual or family occupies with reference to
the prevailing average standards of cultural and material
positions, income and participation in group activities of
the community.

• Kuppuswamy in India prepared a scale based on

education, occupation of the head of the family and total
income which are the three major variables contributing
to the socioeconomic status in urban areas.
 Modified KUPPUSWAMY Socio-Economic Status
A. Education Scale Score B. Occupation Score

1. Profession or Honours 7
1. Profession 10

2. Graduate or post- 6
graduate 2. Semi profession 6

3. Intermediate or post- 5 3. Clerical, shop owner, 5

high school farmer
diploma

4. High school certificate 4 4. Skilled worker 4

5. Middle school 3 5. Semi skilled worker 3

certificate

6. Unskilled worker 2
6. Primary school 2
certificate

7. Unemployed 1
7. Illiterate 1
Family income per month (in Rs.) modified Score
for 2007
= 19,575 12

9788-19574 10
7323-9787 6

4894-7322 4

2936-4893 3

980-2935 2

<979 1

Total Score Socio economic class

26-29 Upper( I )
16-25 Upper – middle ( II )
11-15 middle Lower middle( III )
5-10 lower Upper lower ( IV )
<5 Lower ( V )
 SOCIO-ECONOMIC STATUS
Taking the three categories (Education, Occupation and Family income
per month in INR) into consideration and in accordance with the
modified Kuppuswamy socio-economic status scale ,the total score is
calculated:
1. Education – score is 2
2. Occupation – score is 2
3. Family income (modified for 2007)- score is 4
Total score is 8 , and the family belongs to the Upper-Lower socio-
economic
class.
Per capita income = (total family income / total no. of family
members) =
(12000/5 )= Rs1666.67/-
 ANTHROPOMETRY
The various anthropometric measurements are taken :
FOR UNDER FIVE:
Weight
Height/Length
Mid upper arm circumference
Head circumference
Chest circumference
FOR ADULTS:
Weight
Height
Body Mass Index (BMI)
HEIGHT
STEPS TO FOLLOW FOR
CALCULATING HEIGHT:

1.The shoes should be opened.

2.The person has to stand erect
against a wall with hands close to the
side.
3. The person’s head should not be bent
and eyes should look forward.
4. The person’s ankle, buttocks, scapula
and occipital eminence should touch
the wall.
 WEIGHT

CRITERIA FOR WEIGHT

MEASUREMENT:
1.Calibration
2.The plane should be
horizontal. (bathroom
type weighing machine)
3.To wear minimum
clothes
4.No shoes
5.No Extra support WEIGHING A BABY
BY SALTER SCALE
 HEAD CIRCUMFERENCE

Head circumference is a measurement of a

child’s head around its largest diameter. It
measures the distance from above the
eyebrows and ears and around the back of
the head.

NORMAL VALUE AT BIRTH = 34 cm

 CHEST CIRCUMFERENCE

Normally, head circumference becomes

equal to chest circumference at 6-9 months
and after that chest circumference exceeds
head circumference.

NORMAL VALUE AT BIRTH = 32 cm

 MID UPPER ARM CIRCUMFERENCE

Mid upper arm circumference is the

circumference of the arm at the
midpoint of the acromion process of
scapula and the olecranon process of
ulna.

NORMAL VALUE > 13.5cm

 BODY MASS INDEX
Body Mass Index (BMI) is a simple index of weight-for-height that is
commonly used to classify underweight, overweight & obesity in adults.

BMI for an individual is calculated as:-

BMI = WEIGHT(in kg) /SQUARE OF HEIGHT

(in metre squared)
 CLASSIFICATION OF BMI

CLASSIFICATION BMI (WHO) BMI (INDIAN)

UNDERWEIGHT < 18.50 < 18.5

NORMAL RANGE 18.50 – 24.99 18.5-22.99

OVERWEIGHT 25.00-29.99 23-24.99

OBESE >= 30 >= 25
 MY FINDINGS

SI. NAMEE WEIGHT HEIGHT B.M.I CONCLUSION

NO (Kgs) (mtrs)

1. Mr. 28.4
Shamshuddi 90 1.78 OBESE
n Haldar
2. Mrs. Ayesha
Haldar 59 1.52 25.5 OBESE
 CLINICAL EXAMINATION
General Mrs. Ayesha Haldar Miss Sarika Haldar
Survey
Consciousnes Conscious and Conscious and cooperative
s& cooperative
Cooperation
Build Average Poor

Pallor Absent Absent

Jaundice Absent Absent

Cyanosis Absent Absent

Oedema Absent Absent

Neck veins Not prominent Not prominent

Clubbing absent absent
Neck glands not palpable Not palpable
Pulse 70/min Not known.
Blood pressure 130/80 mm Hg Not known.
Temperature Normal Not known.

Systemic survey Mrs. Ayesha Haldar Miss Sarika Haldar

Respiratory System NAD NAD

Central Nervous NAD NAD

System
 SUMMARY

We interviewed the allotted family on 9th February, 2016.

The family consists of Mr. Shamshuddin Haldar (HOF), his
wife and his daughter. They belong to Upper- Lower
socioeconomic class according to the modified
Kuppuswamy Socio-Economic Status Scale. According to
the calculated BMI, HOF and his wife belongs to the obese
class, however, the daughter was of poor build. The wife of
the HOF was pre-hypertensive. No other significant
findings under clinical examination.
 RECOMMENDATIONS

At individual level :
• The H.O.F was advised to stop his addiction.
• The H.O.F was advised to go for morning walks and exercise
to reduce his weight.
• The wife of the H.O.F was advised to visit a doctor because
she complained of joint pains especially at her knees and
ankles.
• The wife of the H.O.F was advised to reduce weight (morning
walks, exercise), eat more fruits and vegetables, and reduce
salt intake as she was pre-hypertensive.
• The adolescent girl and the mother were advised to visit the
anganwadi centres to avail their services.
At family level :
• The family members were advised to reduce their daily
intake of fried foods.
• The family was advised to go for regular health check ups.

At community level :
• The community should organize awareness campaigns
against obesity.
• The community should encourage its members to take
part in physical activities such as morning walks.
 acknowledgement

• I would like to thank all the respected teachers of the

community medicine department for their guidance.

• I would like to thank the members of the allotted family for

their co-operation.
 bibliography

 Preventive and Social Medicine - Dr.K. Park