Nutritional Status: An Overview of Methods for Assessment

Catherine M. Champagne and George A. Bray Key Points

  • • Obesity is increasing and should be assessed in the healthcare setting and plans made to reduce energy intake and/or to increase physical activity so as to encourage weight loss.
  • • Dietary intake and consumption patterns are challenging areas to evaluate accurately.
  • • Body mass index (BMI), body composition, and routine laboratory testing supplement the information obtained from dietary history and provide further insight into the individual.
  • • Poor diets are observed at various ages, particularly in adolescents and the elderly, often for very different reasons due to the aging process.
  • • Poor diets are observed at various ages, particularly in adolescents and the elderly, though for different reasons.

Keywords Nutrition assessment • Obesity • Body mass index • Dietary intake


This chapter focuses on the whole area of nutritional assessment and explores the wide spectrum of testing available that can aid in determining the health of an individual. This process typically includes in-depth evaluation of both subjective data and objective evaluations of an individual’s food and nutrient intake, components of lifestyle, and medical history. A nutritional assessment provides an overview of nutritional status; it focuses on nutrient intake analysis of the diet, which is then compared with blood tests and physical examination.

C.M. Champagne, PhD (RDN, LDN, FADA, FAND, FTOS) (*)

Department of Nutritional Epidemiology, Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808, USA e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it

G.A. Bray, M.D.

Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA © Springer International Publishing AG 2017

N.J. Temple et al. (eds.), Nutrition Guide for Physicians and Related Healthcare Professionals, Nutrition and Health, DOI 10.1007/978-3-319-49929-1_35

With comprehensive data on diet and biological information, the physician can make an accurate estimate of that person’s nutritional status. Decisions can then be made on an appropriate plan of action to either maintain current health status or referral to counseling or other interventions that may enable the individual to reach a more healthy state. Only with sufficient anthropometric, biochemical, clinical, and dietary information can a plan be drafted.

One part of nutritional assessment is to determine nutritional needs of malnourished individuals suffering from protein and micronutrient deficiencies, in addition to caloric deficiencies. This often requires the use of nutrient-dense diets. But with the advent of the “obesity epidemic” and the epidemic of noncommunicable diseases, we have to deal with dietary composition as a contributing factor.

Body mass index (BMI), defined as weight in kilograms divided by height in meters squared (kg/ m2), remains the initial criterion for assessing overweight and obesity and its risks. Overweight is commonly defined as a BMI of 25 or higher, and obesity as a BMI of 30 or higher. Measurement of the waist circumference to gauge the degree of central adiposity is also recommended.

The epidemic of obesity in the USA started around 1980 and developed rapidly. However, the epidemic appears to have stabilized as there were no significant changes in the prevalence of obesity in youth or adults between 2003-2004 and 2011-2012 [1], but those with a BMI >40 is still rising. Data from NHANES in 2013-2014 indicate that the overall obesity prevalence among adults aged 20 and over (age-adjusted) is now at 37.3%, and among youth aged 2-19 years it has plateaued at 17.2% [2]. The prevalence of obesity is higher in women than in men (36.5% vs 33.7%) [1]. Obesity enhances the risk of diabetes, heart disease, and cancer among others. A recent report by Flegal et al. [3] quantified the health burden of obesity and reported estimates ranged from 5 to 15% for all-cause mortality, -0.2 to 8% for all-cancer incidence, 7-44% for cardiovascular disease incidence, and 3-83% for diabetes incidence; the variability is due to methods used for the population attributable fraction.

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