NUTRITIONAL ASSESSMENT

OF THE ALLOTED FAMILY BY

ANTHROPOMETRIC
MEASUREMENTS &
CLINICAL EXAMINATIONS
MANZIL SAWAN
ROLL NO.- 48
6th 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.
METHODS OF NUTRITIONAL
ASSESSMENT

DIRECT INDIRECT

Anthropometry Ecological survey

Biochemical examination Functional assessment
Clinical examination Vital statistics
Diet survey
 ANTHROPOMETRY
 It is a method for the assessment of nutritional status of
an individual.
 The various anthropometric measurements are:

For UNDER 5YR

For ADULT
CHILD
• Height • Height/Length
• Weight • Weight
• BMI (Body Mass • Head Circumference
Index) • Chest Circumference
• Mid-upper Arm
Circumference
 CRITERIA FOR WEIGHT
MEASUREMENT
 Check for ZERO ERROR.
 Minimum clothing on the person.
 No shoes or extra support.
 The person should stand straight.
 The reading should be taken vertically(no parallax error).
 For adults- Bathroom Weighing Scale
For infant- Weight of (mother+infant)-Weight of mother
or
Salter’s Weighing scale
 CRITERIA OF HEIGHT
MEASUREMENT

 The shoes should be removed.

 Back of heel, calf muscle, buttock, shoulder blade & head
should touch the wall.
 Lower margin of orbit and tragus should be in same line i.e.,
the Frankfurt’s plane should remain horizontal.
 Upto 2 years of age, length is calculated with an infantometer.
 HEAD CIRCUMFERENCE

 The head circumference of a child is measured using a

measuring tape by placing the tape between glabella and
external occipital protuberance above ears and eyebrows.
 Head circumference of a child at birth=34cm
 Head circumference is more than chest circumference at
birth.
 CHEST CIRCUMFERENCE

 The chest circumference of a child is measured using a

measuring tape by placing the tape at the level of the nipple.
 Chest circumference is less than head circumference at birth.
 Chest circumference is equal to head circumference at around 6-
9 months of age.
 Chest circumference becomes more than head circumference
above 9 months of age. This phenomenon is called crossing
over.
 MID UPPER ARM
CIRCUMFERENCE

 The non-dominant arm of a child of age 6 months-5 years should

be chosen.
 The arm of the child should be kept in semi-flexed position.
 The distance is measured by using the measuring tape from the tip
of the acromian process of the scapula to the tip of the olecranon
process of the ulna and the mid-point is marked .
 Then the arm is kept in it’s normal position & MUAC is
measured keeping the lower border of the measuring tape on
the upper margin of the mark.

VALUE OF MUAC INFERENCE

>13.5 cm Satisfactory

12.5-13.5 cm Mild to moderate malnutrition

<12.5 cm Severely malnourished

<11.5cm Severe Acute Malnutrition

 BODY MASS INDEX

 It is a simple index that is used to classify underweight ,

overweight and obesity in adults.
 BMI (Body Mass Index) = weight in kg
height in m2
ACCORDING TO WORLD HEALTH ORGANISATION:-

VALUE INFERENCE
1. <18.5 Underweight

2. 18.5-24.99 Normal

≥25 Overweight
3. 25-29.99 Pre-obese
4. 30-34.9 Obese class 1

5. 35-39.9 Obese class 2

6. ≥40 Obese class 3
ACCORDING TO ASIAN INDIAN STANDARD:-

VALUE INFERENCE
1. <18.5 Underweight
2. 18.5-22.9 Normal
≥23 Overweight
3. 23-24.9 At risk
4. 25-29.9 Obese class 1
5. ≥30 Obese class 2
OBJECTIVES

 To assess the nutritional status of the family

members.
 To take the anthropometric measurements & to see if
there is any deviation.
 To perform clinical examination of the family
members.
 To give recommendations if any.
MATERIALS AND METHODS

 Study Design- Observational, Descriptive, Cross-Sectional

Study.
 Study Area- East End Park, Bedidanga 2nd lane, Kolkata-
700039
 Study Period-12.03.18-25.03.18 & 09.04.18-12.04.18

 Study Population- 5 members of the allotted family.

 Study Tools-
 Measuring Tape
 Bathroom Weighing Scale
 Stethoscope
 Sphygmomanometer
 Camera
 Paper and Pen

 Data Collection-
 Data was collected by interviewing the family members,
checking available records, clinical examination, and
taking measurements.
 OBSERVATIONS
INTRODUCTION TO THE FAMILY:

I. NAME OF THE HEAD OF THE FAMILY- Bikash Das

II. ADDRESS- 221/B, East End Park, Bediadanga 2nd lane,
Kolkata-700039
III. NO.OF FAMILY MEMBERS- 5 members of the allotted
family
IV. TYPE OF FAMILY- Three generation family.
 cont…

V. RELIGION- Hinduism
VI. MOTHER TONGUE- Bengali
VII. HOUSE OWNERSHIP- Own
VIII. TOTAL FAMILY INCOME- Rs.56000/month
IX. PER CAPITA INCOME- Rs.11200/-
X. SOCIO-ECONOMIC STATUS- Upper Middle Class.
[According to Modified Kuppuswamy’s Socio-Economic
Status Scale (2014)].
 FAMILY CHART
SL. NAME AGE S MARITAL RELATION EDUCATION
No. E STATUS WITH HoF
X

1. Bikash Das 62 M Married Self Graduate

2. Sipra Das 54 F Married Wife of HoF Upto Class 12

3. Sourav Das 32 M Married Son of HoF B. Tech

4. Ankita Das 30 F Married Daughter in B. Tech

Law of HoF
5. Avnita Das 12 F ------ Granddaughter -----
months of HoF
 FAMILY CHART
OCCUPA NATU- TYPE INCO- AD- PRESE PAST FAMILY
-TION RE OF OF ME (in DIC- -NT ILLNESS ILLNESS
WORK WORK Rs.) TION ILLNE-
SS

Retired ----- ----- 6000/- ----- Diabetes Cataract Diabetes &

clerk (pension) Hypertension

Housewife ----- Sedentar ----- ----- Diabetes ----- Diabetes

y
Engineer Skilled Sedentar 30,000/- ----- ----- ----- Diabetes
y
Engineer Skilled Sedentar 20,000/- ------ ------ ------ Hypertension
y
------ ----- ----- ----- ----- ------ ------ Diabetes
PRIORITY MEMBERS

The allotted family has following priority members:

1. Avnita Das(12 months)- Under 5yr child.

2. Ankita Das(30 yrs)- Reproductive age group.

3. Sipra Das(54 yrs)-Chronically ill patient.

4. Bikash Das(62 yrs)- Geriatric age group & Chronically

ill patient.
SOCIO-ECONOMIC STATUS
Modified Kuppuswamy’s Socio-Economic Status Scale (2014)
EDUCATION
(A.) EDUCATION SCORE
1. PROFESSION OR HONOUR 7
2. GRADUATE OR POST-GRADUATE 6
3. INTERMEDIATE OR POST HIGH 5
SCHOOL DIPLOMA
4. HIGH SCHOOL CERTIFICATE 4
5. MIDDLE SCHOOL CERTIFICATE 3
6. PRIMARY SCHOOL CERTIFICATE 2
7. ILLITERATE 1
SOCIO-ECONOMIC STATUS
Modified Kuppuswamy’s Socio-Economic Status Scale (2014)
OCCUPATION
(B.) OCCUPATION SCORE
1. PROFESSION 10
2. SEMI-PROFESSION 6
3. CLERICAL, SHOP OWNER, FARMER 5

4. SKILLED WORKER 4
5. SEMI-SKILLED WORKER 3
6. UNSKILLED WORKER 2
7. UNEMPLOYED 1
SOCIO-ECONOMIC STATUS
Modified Kuppuswamy’s Socio-Economic Status Scale (2014)
TOTAL FAMILY INCOME
FAMILY INCOME PER MONTH (in
(C.) Rs.) SCORE
Modified for 2014
1. =36,997 12

2. 18,948-36,996 10

3. 13,874-18,497 6

4. 9,249-13,873 4

5. 5,547-9,248 3

6. 1,866-5,546 2

7. <1,865 1
SOCIO-ECONOMIC STATUS
According to Modified Kuppuswamy’s Socio-Economic Status
Scale (2014), the total score of the allotted family is :

SCORE
EDUCATION 6
OCCUPATION 5
FAMILY INCOME 12

TOTAL SCORE 23
 SOCIO-ECONOMIC STATUS
According to Modified Kuppuswamy’s Socio-Economic Status Scale
(2014),
SOCIO-ECONOMIC
TOTAL SCORE
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)

the Socio-Economic Status of the allotted family is:

UPPER-MIDDLE CLASS.
 ANTHROPOMETRIC MEASUREMENTS OF
THE MEMBERS OF MY ALLOTED FAMILY

 FOR ADULTS:-

ANTHROPOMETRIC Bikash Das Sipra Das Saurav Ankita

MEASUREMENTS Das Das

HEIGHT (in cm) 167 162 164 160

WEIGHT (in kg) 78 69 74 68

BODY MASS 27.97 26.29 27.51 26.56

INDEX(kg/m2)
ANTHROPOMETRIC Bikash Das Sipra Das Saurav Das Ankita Das
MEASUREMENTS

CONCLUSION Pre- Obese Pre- Obese Pre- Obese Pre- Obese

(According to WHO)

CONCLUSION Obese Class Obese Class Obese Class Obese Class

(According to Asian 1 1 1 1
Indian classification)
 FOR UNDER 5 CHILD:

Parameters NORMAL(FOR 12 FINDINGS

MONTHS)
WEIGHT 8.9 (+/- 2 S.D.) kg 9.5 kg
(7.0 – 11.5 kg)
HEIGHT 74 (+/- 2 S.D.) cm 75cm
(68.9 – 79.2 cm)

MID UPPER ARM >13.5 cm 14cm

CIRCUMFERENCE
HEAD 44.9cm(+/- 2SD) 46.2cm
CIRCUMFERENCE
CHEST More than head 48.4cm
CIRCUMFERENCE circumference

All the anthropometric measurements of the child are within

normal range.
 CILNICAL EXAMNATION
 FOR ADULTS:

S CLINCAL Bikash Das Sipra Das Saurav Das Ankita Das

L. EXAMINA
N TION
O.

1. General Normal Built Normal Built Normal Built Normal Built

Appearance

2. Hair Normal Normal Normal Normal

3. Face Normal Normal Normal Normal

4. Eyes Conjunctiva- Conjunctiva- Conjunctiva- Conjunctiva-

Normal Normal Normal Normal
Cornea-Normal Cornea-Normal Cornea-Normal Cornea-Normal
SL CLINCAL Bikash Sipra Das Saurav Das Ankita Das
. EXAMINATI Das
N ON
O.
5. Lips Normal Normal Normal Normal

6. Tongue Normal Normal Normal Normal

7. Teeth Normal Normal Normal Normal

8. Gums Normal Normal Normal Normal

SL CLINCAL Bikash Sipra Das Saurav Das Ankita Das
. EXAMINATI Das
N ON
O.

9. Glands Not Palpable Not Palpable Not Palpable Not Palpable

10. Skin Normal Normal Normal Normal

11. Nails Normal Normal Normal Normal

12. Edema Absent Absent Absent Absent

The clinical examination of the adult family members shows no

detectable abnormality.
FOR UNDER 5 CHILD:

SL. CLINCAL EXAMINATION FINDINGS

NO.
1. General Appearance Normal Built

2. Hair Normal

3. Face Normal

4. Eyes Conjunctiva-Normal
Cornea-Normal
5. Lips Normal

6. Tongue Normal
 SL. CLINCAL EXAMINATION FINDINGS
NO.
7. Teeth Normal

8. Gums Normal

9. Glands Not enlarged

10. Skin Normal

11. Nails Normal

12. Edema over the dependent Absent

parts

The clinical examination of the child shows no detectable

abnormality.
 SUMMARY

The allotted family is a Three generation family residing in 221/B,

East End Park, Bedidanga, Kolkata and has 5 members. Bikash Das
is the HoF. There are 4 priority members in the family. The per
capita income is Rs. 11200. According to Modified Kuppuswamy’s
Scale(2014) the family belong to Upper-Middle Class.
All adult members of the family are Pre-Obese according to
WHO classification and Obese Class 1 according to Asian
Indian Classification of BMI. On Clinical Examination no
abnormality was detected.
The anthropometric measurement of the under 5 child is within
normal range. On Clinical Examination no signs of malnutrition
was detected.
RECOMMENDATIONS

A.) At individual level:

 The adult members are advised to engage in physical activity
like brisk walking for at least 30 minutes 5 days a week.
 Mr Bikash Das and Mrs Sipra Das should regularly
visit the nearest health care facility for regular
checkup.
B.) At family level:
 They are advised to purchase a Bathroom Weighing
Scale for assessment of weight at regular intervals.
 Mr Sourav Das and Mrs. Ankita Das are susceptible
to develop Type 2 Diabetes Mellitus and should make
life style modifications.

C.) At community level:

 The community should promote awareness about the
benefits of physical exercise and encourage the same
by organising Yoga Camps and marathons.
ACKNOWLEDGEMENT
I would like to thank the Head of the Department and the
teachers of Community Medicine Department of our college
for the regular briefing and their methods for making us learn
the fundamentals.
I would also like to thank the members of my allotted family
for their kind co-operation.
This wouldn’t have been possible without the contribution of
my friends, and also my field partner Indradeep Saha.
BIBLIOGRAPHY

 Park K. Park’s Textbook of Preventive And

Social Medicine. 24th Edition. Bhanot
Publishers: Jabalpur. 2015. 399,649,
663,690.
 Practical Guide Book. Page 74-84 & 56-70.