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1: Introduction

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    Nutritional assessment procedures were first used in surveys designed to describe the nutritional status of populations on a national basis. The assessment methods used were initially described following a conference held in 1932 by the Health Organization of the League of Nations.

    In 1955, the Interdepartmental Committee on Nutrition for National Defense (ICNND) was organized to assist low-income countries in assessing the nutritional status of their populations and to identify problems of malnu­trition and the ways in which they could be solved. The ICNND teams conducted medical nutri­tion surveys in 24 countries. A comprehensive manual was then produced and later, updated guidance issued (ICNND, 1984) with the intention of standardizing both the assessment methods used for the collection of nutri­tion survey data and the inter­pretation of the results.

    On the recom­men­dation of a World Health Organization (WHO) Expert Committee on Medical assessment of Nutritional Status, a second publication was prepared by Jelliffe (1966) in consultation with 25 specialists from various countries. This monograph was directed specifically at the assessment of the nutritional status of vulnerable groups in low-income countries of the world.

    Many of the methods described in this monograph are still used by the the U.S. Demographic and Health Surveys (DHS) Program to collect representative data on popu­lation, health, HIV, and nutri­tion, and about 30 indicators supporting the Sustainable Development Goals. The data are used to identify public health nutri­tion problems so that effective inter­vention programs can be designed. The U.S. DHS program has conducted more than 400 surveys in over 90 low‑ and middle-income countries since 1984.

    Many higher income countries collect national data on the nutritional status of the popu­lation, some (e.g., the U.S. and the U.K.) collecting data on an ongoing basis using nutri­tion surveillance systems. In the past, these systems have often targeted high-risk populations, especially low-income mothers, children under five, and pregnant women. Now, with the growing awareness of the role of nutri­tion as a risk factor for chronic diseases, surveillance systems often encompass all age groups.

    • 1.1: New developments in nutritional assessment
      This page discusses the evolution of nutritional assessment through non-invasive methods such as dried blood samples and all-in-one platforms, particularly in low-income countries. It highlights the potential of e- and m-Health technologies to enhance nutrition-related behaviors, the expansion of point of care technology, and the emergence of personalized nutrition via omic sciences.
    • 1.2: Nutritional assessment systems
      This page outlines the role of nutritional assessments in public health, including forms like surveys and screenings to identify at-risk groups and guide interventions against malnutrition. It emphasizes the importance of monitoring and evaluation to ensure the effectiveness of these interventions and discusses personalized nutrition approaches tailored to individual health goals, supported by evidence-based medicine.
    • 1.3: Nutritional assessment methods
      This page discusses the evolution of nutritional assessment, focusing on comprehensive methods that go beyond deficiency, particularly in low and middle-income countries. It highlights the use of functional tests, biomarkers, and technology in evaluating nutrient status and chronic diseases. The UNICEF Nutrition Strategy 2020–2030 underscores the need for data on maternal and child nutrition determinants, including socioeconomic factors, to address malnutrition effectively.
    • 1.4: Nutritional assessment indices and indicators
      This page discusses the importance of context in interpreting raw measurements, particularly in nutritional assessments through indices like height-for-age and BMI. It highlights the use of Z-scores against reference limits to identify conditions such as stunting or underweight. It emphasizes WHO's recommendations on anthropometric indicators, advocating for a combination with dietary and biochemical markers for thorough risk evaluation.
    • 1.5: The design of nutritional assessment systems
      This page outlines the critical factors in designing nutritional assessment systems, emphasizing the importance of ethical research and informed consent. It highlights the value of clinical trial guidelines and transparent reporting, alongside the significance of using appropriate sampling methods—preferably probability methods—to minimize bias.
    • 1.6: Important characteristics of assessment measures
      This page analyzes key aspects of nutritional assessment measures, including validity, reproducibility, precision, and accuracy. It addresses concepts of measurement bias, particularly in retrospective studies, and the importance of controlling confounding variables. The definitions of sensitivity and specificity in malnutrition assessment are emphasized, along with the impact of prevalence on predictive values of tests.
    • 1.7: Evaluation of nutritional assessment indices
      This page discusses nutritional assessment indices in population studies, emphasizing the comparison with reference values from healthy populations using percentiles, Z-scores, and cutoff points. It highlights 25-hydroxyvitamin D for categorizing vitamin D status and the importance of ROC curves for selecting accurate nutritional indices.

    This page titled 1: Introduction is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Rosalind S. Gibson via source content that was edited to the style and standards of the LibreTexts platform.