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BI8.1-6 | Vitamins and Nutrition — SDL Guide (Part 3)

Nutritional Assessment

Nutritional assessment is a core clinical skill (BI8.5, BI8.6). It uses four components — the ABCD framework:

A — Anthropometric measurements:
- Weight, height, BMI (kg/m²)
- Mid-upper arm circumference (MUAC) — field tool for acute malnutrition in children
- Waist circumference (central obesity risk)
- Skinfold thickness — estimates body fat
- Z-scores: weight-for-age, height-for-age, weight-for-height (WHO growth charts)
- Stunting (low height-for-age) = chronic undernutrition; Wasting (low weight-for-height) = acute

B — Biochemical markers:
- Serum albumin (half-life 20 days — chronic protein status)
- Serum transferrin / prealbumin (shorter half-life — acute protein status)
- Haemoglobin and iron studies (iron deficiency anaemia — India's largest nutritional deficiency)
- Serum vitamin levels (25-OH-D, retinol, B12, folate)
- Blood glucose, lipid profile

C — Clinical examination:
- Skin, hair, nails, mucous membranes, eyes — specific signs of vitamin/mineral deficiency
- Muscle wasting, oedema (kwashiorkor)

D — Dietary assessment:
- 24-hour dietary recall, food frequency questionnaire, food diary
- Compared against ICMR Recommended Dietary Intakes for Indians

India-specific context: India carries a double burden — undernutrition (50% of under-5 children stunted/wasted) AND overnutrition (diabetes, obesity epidemic in urban populations).

Figure: Nutritional Assessment