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documented.\nMeasurements\tof\theight\tcan\tbe\tobtained\tusing\ta\tdirect\tor\tan\tindirect\tapproach.\tThe\tdirect\tmethod\ninvolves\ta\tstadiometer,\tand\tthe\tadult\tmust\n\tbe\table\tto\tstand\tstraight\tor\trecline\tflat.\tIndirect\tmethods,\nincluding\tknee-height\tmeasurements,\tarm\tspan,\tor\trecumbent\tlength\tusing\ta\ttape\tmeasure,\tmay\tbe | [
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options\tfor\tthose\twho\tcannot\tstand\tor\tstand\tstraight,\tsuch\tas\tindividuals\twith\tscoliosis,\tkyphosis\n(curvature\tof\tthe\tspine),\tcerebral\tpalsy,\tmuscular\tdystrophy,\tcontractures,\tparalysis,\tor\tthose\twho\nare\tbedridden\t(see\t\nAppendix\t6\n).\tRecumbent\n\theight\tmeasurements\tmade\twith\ta\ttape\tmeasure\twhile | [
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] |
).\tRecumbent\n\theight\tmeasurements\tmade\twith\ta\ttape\tmeasure\twhile\nthe\tperson\tis\tin\tbed\tmay\tbe\tappropriate\tfor\tindividuals\tin\tinstitutions\twho\tare\tcomatose,\tcritically\till,\nor\tunable\tto\tbe\tmoved.\tHowever,\tthis\tmethod\tcan\tbe\tused\tonly\twith\tpatients\twho\tdo\tnot\thave\nmusculoskeletal\tdeformities\tor\tcontractures\t(see\t\nBox\t5.4\n).\nBOX\t5.4 | [
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Using\tHeight\tand\tWeight\tto\tAssess\ta\tHospitalized\tPatient’s\nNutritional\tStatus\n•\t\nMeasure.\tDo\tnot\tjust\task\ta\tperson’s\theight.\n•\t\nMeasure\tweight\t(at\tadmission\tat\tadmission\tand\tcurrent).\n•\t\nDetermine\tpercentage\tof\tweight\tchange\tover\ttime\t(weight\tpattern).\n•\t\nDetermine\tpercentage\tabove\tor\tbelow\tusual\tor\tideal\tbody\tweight. | [
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] |
•\t\nDetermine\tpercentage\tabove\tor\tbelow\tusual\tor\tideal\tbody\tweight.\nIdeal\tweight\tfor\theight\treference\tstandards\tsuch\tas\tthe\tMetropolitan\tLife\tInsurance\tTables\tfrom\n1959\tand\t1983\tor\tthe\tNational\tHealth\tand\tNutrition\n\tExamination\tSurvey\tpercentiles\tare\tno\tlonger\nused.\tA\tcommonly\tused\tmethod\tof\tdetermining\tideal\tbody\tweight\tis\tthe\tHamwi\tEquation\t( | [
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Hamwi\tet\nal,\t1964\n).\tIt\tdoes\tnot\tadjust\tfor\tage,\trace,\tor\tframe\tsize\tand\tits\tvalidity\tis\tquestionable.\tNonetheless,\nit\tis\tin\twidespread\tuse\tby\tclinicians\tas\ta\tquick\tmethod\tfor\testimation\tof\tideal\tweight:\nMen:\t106\tlb\tfor\tfirst\t5\tfeet\tof\theight\tand\t6\tlb\tper\tinch\tover\n\t5\tfeet;\tor\t6\tlb\tsubtracted\tfor\teach\ninch\tunder\t5\tfeet | [
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highly\tindicative\tof\tthe\textent\tand\tseverity\tof\tan\tindividual’s\tillness.\tThe\tCharacteristics\tof\nMalnutrition\tdefined\tby\tthe\tAcademy\tof\tNutrition\tand\tDietetics\t(AND)\tand\tthe\tAmerican\tSociety\tfor\nParenteral\tand\tEnteral\tNutrition\t(ASPEN)\n\tserve\tas\ta\tbenchmark\tfor\tevaluating\tweight\tloss\t(\nWhite\tet\nal,\t2012\n):\n• | [
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White\tet\nal,\t2012\n):\n•\t\nSignificant\tweight\tloss:\t5%\tloss\tin\ta\tmonth,\t7.5%\tloss\tin\t3\tmonths,\t10%\tloss\tin\t6\tmonths\n•\t\nSevere\tweight\tloss:\t>5%\tweight\tloss\tin\ta\tmonth,\t>7.5%\tweight\tloss\tin\t3\tmonths,\t>10%\nweight\tloss\tin\t6\tmonths\n•\t\nFor\texample,\tif\ta\tperson’s\tusual\tweight\tis\t200\tlb\tand\the\tnow\tweighs\t180\tlb,\tthat\tis\ta\tweight\nloss\tof\t20\tlb.\n• | [
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loss\tof\t20\tlb.\n•\t\nIf\tthis\tperson\thas\tlost\tthis\t10%\tin\t2\tmonths,\tthat\twould\tbe\tmore\tthan\t7.5%\tin\t3\tmonths\tand\nconsidered\tSEVERE\tweight\tloss.\nAnother\tmethod\tfor\tevaluating\tthe\tpercentage\tof\n\tweight\tloss\tis\tto\tcalculate\tan\tindividual’s\tcurrent\nweight\tas\ta\tpercentage\tof\tusual\tweight.\t\nUsual\tbody\tweight\t(UBW)\n\tis\ta\tmore\tuseful\tparameter\nthan | [
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Usual\tbody\tweight\t(UBW)\n\tis\ta\tmore\tuseful\tparameter\nthan\t\nideal\tbody\tweight\t(IBW)\n\tfor\tthose\twho\tare\texperiencing\tinvoluntary\tweight\tloss.\tHowever,\none\tproblem\twith\tusing\tUBW\tis\tthat\tit\tmay\tdepend\ton\tthe\tpatient’s\tmemory.\nBody\tmass\tindex\nThe\t\nQuetelet\tindex\t(W/H\n2\n)\n\tor\tthe\t\nbody\tmass\tindex\t(BMI)\n\tis\tused\tto\n\tdetermine\twhether\tan | [
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Stensland\tand\tMargolis,\t1990\n).\tNumerous\nresearch\tstudies\thave\tdemonstrated\tthat\tindividuals\twith\ta\thigher\tBMI\tare\tmore\tlikely\tto\texperience\nobesity-related\thealth\tissues\t(\nFlegal\tet\tal,\t2013\n),\thowever\tthere\tis\tno\tsingle\tbody\tfat\tmeasure\tthat\nclearly\tdifferentiates\tbetween\thealth\tfrom\tdisease\tor\trisk\tof\tdisease.\tBMI\tis\tcalculated\tas\tfollows: | [
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Metric:\tBMI\t=\tWeight\t(kg)\t÷\tHeight\t(m)\n2\nEnglish:\tBMI\t=\tWeight\t(lb)\t÷\tHeight\t(in)\n2\n\t×\t703\nNomograms\tare\talso\tavailable\tto\tcalculate\tBMI,\tas\tare\tvarious\tcharts\t(see\t\nAppendix\t8\n).\tThe\nClinical\n\tInsight\tbox:\t\nCalculating\tBMI\tand\tDetermining\tAppropriate\tBody\tWeight\n\tgives\tan\texample\tof\nthe\tBMI\tcalculation.\nCLINICAL\tINSIGHT | [
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Example:\tWoman\twho\tis\t5′8″\t(68\tin)\ttall\tand\tweighs\t185\tpounds\t(lb)\nStep\t1:\tCalculate\tcurrent\tBMI:\nFormula:\n(Metric)\nWeight\t(kg)\t84\tkg\t÷\tHeight\t(m\n2\n)\t\n(1.72\tm)\t×\t(1.72\tm)\t=\t84\t÷\t2.96\tm\n2\n\t=\tBMI\t=\t28.4\n\t=\noverweight\nStep\t2:\tAppropriate\tweight\trange\tto\thave\ta\tBMI\tthat\tfalls\tbetween\t18.5\tand\t24.9\n18.5\n(18.5)\t×\t(2.96)\t=\t54.8\tkg\t=\t121\tlb\n24.9 | [
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18.5\n(18.5)\t×\t(2.96)\t=\t54.8\tkg\t=\t121\tlb\n24.9\n(24.9)\t×\t(2.96)\t=\t73.8\tkg\t=\t162\tlb\nAppropriate\tweight\trange\t=\t121\t−\t162\tlb\tor\t54.8\t−\t73.8\tkg\nFormula\t(English)\tWeight\t(lb)\t\n÷\t(Height\t[in]\t×\tHeight\t[in])\t×\t703\t=\tBMI\nBMI\n,\tBody\tmass\tindex.\nStandards\tclassify\ta\tBMI\tof\tless\tthan\t18.5\tfor\tan\n\tadult\tas\tunderweight,\ta\tBMI\tbetween\t25\tand\t29.9 | [
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adult\tas\tunderweight,\ta\tBMI\tbetween\t25\tand\t29.9\nas\toverweight,\tand\ta\tBMI\tgreater\tthan\t30\tas\tobese.\tA\thealthy\tBMI\tfor\tadults\tis\tconsidered\tbetween\n18.5\tand\t24.9\t(\nCDC,\t2018\n).\tThere\tare\tsome\tclinical\tlimitations\tto\tthe\tuse\tof\tBMI\tas\ta\tmeasure\tof\nbody\tfatness.\tAge,\tsex,\tethnicity,\tand\tmuscle\tmass\tcan\tinfluence\tthe\trelationship\tbetween\tBMI\tand | [
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body\tfat.\tBMI\tdoes\tnot\tdistinguish\tbetween\texcess\tfat,\n\tmuscle,\tand\tbone\tmass\tor\tfat\tdistribution.\nBMI\tis\tcorrelated\twith\tweight\tmore\tthan\tfat\t(\nCDC,\t2018\n).\tBMI\tvalues\ttend\tto\tincrease\twith\tage\tand\nthereby\tincreasing\trisk\tfor\tobesity-related\thealth\tissues.\tHowever,\tfor\tolder\tadults\twith\tchronic | [
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conditions,\tthere\tis\tincreasing\tevidence\tthat\tan\tobesity\tparadox\texists\tin\twhich\tan\televated\tBMI\tis\nassociated\twith\tlower\tall-cause\tand\tcardiovascular\tmortality\n\tcompared\twith\tpatients\twith\tlower\nweight\t(\nWinter\tet\tal,\t2014\n;\t\nHainer\tand\tAldhoon-Hainerová,\t2013\n;\tsee\t\nChapter\t19\n).\nBody\tcomposition\nBody\tcomposition | [
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] |
;\tsee\t\nChapter\t19\n).\nBody\tcomposition\nBody\tcomposition\n\tis\ta\tcritical\tcomponent\tof\tnutrition\tassessment\tand\tmedical\tstatus.\tIt\tis\tused\nconcurrently\twith\tother\tassessment\tfactors\tto\tdifferentiate\tthe\testimated\tproportions\tof\tfat\tmass,\nsoft\ttissue\tbody\tmass,\tand\tbone\tmass.\tFor\texample,\tmuscular\tpeople\n\tand\tathletes\tmay\tbe\twrongly | [
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free\tbody\tmass,\tfat\tpatterning,\tand\tbody\tdimensions\tand\tproportions;\tblacks\thave\tgreater\tbone\nmineral\tdensity\tand\tbody\tprotein\tcompared\twith\twhites\t(\nWagner\tand\tHeyward,\t2000\n).\tIn\taddition,\noptimal\tBMIs\tfor\tAsian\tpopulations\tmust\tbe\tin\tthe\tlower\tranges\tof\t“normal”\tfor\toptimal\thealth\tto | [
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sarcopenia,\tsarcopenic\tobesity\t(individuals\twith\tobesity,\tlow\tmuscle\tmass,\tlow\tmuscle\tstrength,\tand\nlow\n\tphysical\tperformance),\tand\tosteosarcopenic\tobesity\t(individuals\twith\tobesity,\tbone\tloss,\tlow\nmuscle\tmass,\tlow\tmuscle\tstrength,\tand\tlow\tphysical\tperformance)\t(\nPrado\tand\tHeymsfield,\t2014\n).\nSubcutaneous\tfat\tin\tskinfold\tthickness | [
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assumes\tthat\t50%\tof\tbody\nfat\tis\tsubcutaneous.\tBecause\tof\tlimitations\twith\taccuracy\tand\treproducibility,\tthese\tmeasurements\nare\tnot\tused\troutinely\tin\tclinical\tsettings.\nCircumference\tmeasurements\nCircumference\tmeasurements\tmay\tbe\tuseful\tin\thealth\tcare\tsettings\tin\twhich\tthese\tmeasurements | [
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are\trecorded\tperiodically\t(e.g.,\tmonthly\tor\tquarterly)\tand\ttracked\tover\ttime\tto\tidentify\ttrends\tand\npotential\n\trisk\tfactors\tfor\tchronic\tconditions.\tHowever,\tin\tacutely\till\tindividuals\twith\tdaily\tfluid\tshifts\nmeasures\tof\tarm\tcircumference\tand\ttriceps\tskinfold\t(TSF)\tmeasurements\tusually\tare\tnot\tperformed. | [
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measurements.\tNC\tis\tmeasured\ton\tbare\tskin\tbetween\tthe\tmidcervical\tspine\tand\tmidanterior\tneck\njust\tbelow\tthe\tlaryngeal\tprominence\t(the\tAdam’s\tapple)\twith\tthe\thead\tin\tthe\tFrankfurt\tplane\n(looking\tstraight\tahead).\tThe\ttape\tshould\tbe\tas\tclose\tto\thorizontal\tas\tanatomically\tfeasible\t(i.e.,\tthe\ntape\tline\tin\tthe\tfront\tof\tthe | [
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with\thypertension\tand\ttype\t2\tdiabetes\t(\nCoelho\tet\tal,\t2016\n).\tFindings\tfrom\tstudy\tof\ta\tpredominantly | [
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African\n\tAmerican\tcohort\tinclude\tsignificant\tcorrelations\tbetween\tserum\tinsulin,\ttriglycerides,\tLDL\ncholesterol\tlevels,\tand\tNC\t(\nArnold\tet\tal,\t2014\n).\nNC\tcan\tbe\tused\tas\ta\treliable\ttool\tto\tidentify\tadolescents\twith\thigh\tBMIs\t(\nKelishadi\tet\tal,\t2016\n;\nAndroutsos,\t2012\n).\tThe\tCanadian\tHealth\tMeasures\tSurvey\thas\tpublished\treference\tdata\tfor | [
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interpretation\tof\tNC\tmeasurements\tin\tCanadian\tchildren\t(\nKatz\tet\tal,\t2014\n).\nBioelectrical\timpedance\tanalysis\t(BIA)\nBioelectrical\tImpedance\tAnalysis\t(BIA)\n\testimates\tbody\tcomposition\tand\tcellular\tactivity\tby\nmeasuring\tthe\tbulk\tof\tthe\telectrical\timpedance\tin\tthe\tbody.\tThe\tbody\tcomposition\tanalysis\ttechnique | [
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intracellular\tand\textracellular\tbody\twater\n(i.e.,\tthird\tspacing\tof\tbody\tfluids),\tfat-free\tmass,\tpercent\tbody\tfat,\tphase\tangle,\tand\tcellular\nmetabolism.\tThe\tevaluation\tof\tcellular\tmetabolism\tis\tbased\ton\tthe\tphase\tangle.\tThe\tphase\tangle\nmeasures\tthe\trelationship\tbetween\treactance,\tresistance,\tand\timpedance\tto\tpredict\tthe\tintegrity\tof | [
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The\tBIA\tmethod\tis\tsafe,\tnoninvasive,\tportable,\tand\trapid.\tFor\taccurate\tresults\tthe\tpatient\tshould\nbe\twell\thydrated;\thave\tnot\texercised\tin\tthe\tprevious\t4\tto\t6\thours;\tand\thave\n\tnot\tconsumed\talcohol,\ncaffeine,\tor\tdiuretics\tin\tthe\tprevious\t24\thours.\tIf\tthe\tperson\tis\tdehydrated,\ta\thigher\tpercentage\tof | [
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using\tBIA\tin\tcritical\tcare\npatients.\tMonitoring\ttrends\tin\tdata\tmay\tbe\thelpful.\tBIA\tis\tcontraindicated\tfor\tindividuals\twho\tare\npregnant,\tdue\tto\tethical\tconcerns,\tor\twho\thave\tan\timplanted\tpacemaker\tor\tdefibrillator\t(\nBuch\tet\tal,\n2012\n;\t\nLee\tand\tGallagher,\t2008\n).\t\nFig.\t5.4\n\tillustrates\ta\tBIA\ttest.\nFIG.\t5.4\nBioelectrical\timpedance\tanalysis. | [
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illustrates\ta\tBIA\ttest.\nFIG.\t5.4\nBioelectrical\timpedance\tanalysis.\n\tSource:\t\n(Image\treproduced\twith\tpermission\tof\tImpediMed\tLimited.)\nCircumference\tmeasurements\tin\tchildren\nHead\tcircumference\n\tmeasurements\tare\tuseful\tin\tchildren\tyounger\tthan\t3\tyears\tof\tage,\tprimarily | [
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as\tan\tindicator\tof\tnonnutritional\tabnormalities\t(i.e.,\tcongenital\tmicrocephaly,\thydrocephalus).\nUndernutrition\tmust\tbe\tvery\tsevere\tto\taffect\thead\n\tcircumference;\tsee\t\nBox\t5.5\n\tand\t\nChapter\t15\n.\nBOX\t5.5\nMeasuring\tHead\tCircumference\nIndications\n•\t\nHead\tcircumference\tis\ta\tstandard\tmeasurement\tfor\tserial\tassessment\tof\tgrowth\tin\tchildren | [
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from\tbirth\tto\t36\tmonths\tand\tin\tany\tchild\twhose\thead\tsize\tis\tin\tquestion.\nEquipment\n•\t\nPaper\tor\tmetal\ttape\tmeasure\t(cloth\tcan\tstretch)\tmarked\tin\ttenths\tof\ta\tcentimeter\tbecause\ngrowth\tcharts\tare\tlisted\n\tin\t0.5-cm\tincrements\nTechnique\n•\t\nThe\thead\tis\tmeasured\tat\tits\tgreatest\tcircumference. | [
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•\t\nThe\tgreatest\tcircumference\tis\tusually\tabove\tthe\teyebrows\tand\tpinna\tof\tthe\tears\tand\taround\nthe\toccipital\tprominence\tat\tthe\tback\tof\tthe\tskull.\n•\t\nMore\tthan\tone\tmeasurement\tmay\tbe\tnecessary\tbecause\tthe\tshape\tof\tthe\thead\tcan\taffect\tthe\nlocation\tof\tthe\tmaximum\tcircumference.\n•\t\nCompare\tthe\tmeasurement\twith | [
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•\t\nCompare\tthe\tmeasurement\twith\n\tthe\tNational\tCenter\tfor\tHealth\tStatistics\tstandard\tcurves\nfor\thead\tcircumference\t(see\t\nAppendices\t5\n\tand\t\n9\n).\nData\tfrom\tHockenberry\tMJ,\tWilson\tD:\t\nWong’s\tnursing\tcare\tof\tinfants\tand\tchildren\n,\ted\t9,\tSt\tLouis,\t2015,\nMosby.\nMeasuring\tcircumference\nMidarm\tcircumference\t(MAC) | [
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Mosby.\nMeasuring\tcircumference\nMidarm\tcircumference\t(MAC)\n\tis\tmeasured\tin\tcentimeters\thalfway\tbetween\tthe\tacromion\tprocess\nof\tthe\tscapula\tand\tthe\tolecranon\tprocess\tat\tthe\ttip\n\tof\tthe\telbow.\tMAC\tshould\tbe\tmeasured\twhen\nassessing\tfor\tnutritional\tstatus\tof\tchildren\tand\tcompared\twith\tthe\tstandards\tdeveloped\tby\tWHO\tfor | [
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children\taged\t6\tto\t59\tmonths\tof\tage\t(de\tOnis\tet\tal,\t1997).\tIt\tis\tan\tindependent\tanthropometric\nassessment\ttool\tin\tdetermining\tmalnutrition\tin\tchildren.\nCircumference\tmeasurements\tin\tadults\nMAC\tis\tmeasured\tthe\tsame\tway\tin\tadults\tas\tin\tchildren.\tCombining\n\tMAC\twith\t\ntriceps\tskin\tfold\n(TSF) | [
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inches\t(102\tcm)\tfor\tmen\n\tand\tgreater\tthan\t35\tinches\t(88\tcm)\tfor\twomen\tis\tan\tindependent\trisk\tfactor\nfor\tmetabolic\tdisease\t(\nCDC,\t2014\n;\t\nStone\tet\tal,\t2013\n).\tThese\tmeasurements\tmay\tnot\tbe\tas\tuseful\tfor\nthose\tless\tthan\t60\tinches\ttall\tor\twith\ta\tBMI\tof\t35\tor\tgreater\t(\nCDC,\t2014\n).\tWC\tis\tconsidered\tto\tbe\ta | [
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CDC,\t2014\n).\tWC\tis\tconsidered\tto\tbe\ta\nmore\tvalid\tpredictor\tof\tmetabolic\trisk\tthan\tBMI,\texcept\twhen\tBMI\tis\tgreater\tthan\tor\tequal\tto\t35\n(\nCDC,\t2018\n). | [
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FIG.\t5.5\nMeasuring\ttape\tposition\tfor\twaist\tcircumference.\nTo\tdetermine\tthe\t\nwaist-to-hip\tratio\t(WHR)\n,\tdivide\tthe\twaist\tmeasurement\tby\tthe\thip\nmeasurement.\tThe\tWHO\tdefines\tthe\tratios\tof\tgreater\tthan\t9.0\tin\tmen\tand\tgreater\tthan\t8.5\tin\twomen\nas\tone\tof\tthe\tdecisive\tbenchmarks\tfor\tmetabolic\tsyndrome\tand\tis\tconsistent\twith\tfindings\tof | [
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] |
research\tpredicting\tall\tcause\tand\tcardiovascular\tdisease\tmortality\n\t(\nSrikanthan\tet\tal,\t2009\n;\t\nWelborn\nand\tDhaliwal,\t2007\n).\nFig.\t5.5\n\tshows\tthe\tproper\tlocation\tto\tmeasure\twaist\t(abdominal)\tcircumference.\nThe\twaist-to-height\tratio\t(WHtR)\tis\tdefined\tas\tthe\twaist\tcircumference\tdivided\tby\tthe\tmeasured | [
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0.04358844459056854,
0.008706494234502316,
-0.006273007486015558,
-0.04609096422791481,
-0.0019905278459191322,
0.006389120128005743,
0.005395811051130295,
-0.02682815119624138,
0.044556617736816406,
0.0974002480506897,
-0.029932428151369095,
-0.004691408481448889,
-0.06351735442876816,
-0.012635366059839725,
0.014533651992678642,
-0.06389109790325165,
-0.03267602622509003,
-0.008208568207919598,
0.138046994805336,
-0.03667057678103447,
-0.019361456856131554,
0.04353487491607666,
0.08346979320049286,
0.06864985823631287,
-0.0640018954873085,
0.03716457262635231,
0.012454969808459282,
0.09931003302335739,
-0.04962048679590225,
-0.03286470100283623,
0.07026059180498123,
-0.003982842434197664,
-0.028317619115114212,
-0.04733816906809807,
0.05308714509010315,
0.0889139398932457,
0.09390738606452942,
-0.024381887167692184,
0.06015101075172424,
0.13110657036304474,
0.07963338494300842,
0.03738078102469444,
-0.011369007639586926
] |
).\tDesirable\tratios\tare\tless\tthan\t0.5\tin\tadults\t40\tyears\nand\tyounger,\tbetween\t0.5\tand\t0.6\tin\tadults\taged\t40\tto\t50\tyears,\tand\t0.6\tor\tless\tin\tadults\tover\t50.\nThese\ttargets\tapply\tto\tboth\tmales\tand\tfemales\tand\ta\tvariety\tof\tethnic\tgroups.\tFor\texample,\ta\tBMI\tof\n25\tis\tequivalent\tto\ta\tWHtR\tof\t0.51.\t\nTable\t5.7\n\tprovides\ta\tguide\tto\tinterpreting | [
-0.011547021567821503,
-0.000215000836760737,
0.05033367499709129,
-0.044567812234163284,
-0.07184364646673203,
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0.0978759378194809,
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0.07843152433633804,
0.10363749414682388,
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0.0661187469959259,
0.02712371200323105,
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0.024362368509173393,
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0.02493540197610855,
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0.002332651289179921,
0.03442005440592766,
0.006150375120341778,
0.014998698607087135,
0.0240867231041193,
0.05364886671304703,
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0.006931775715202093,
0.007304584141820669,
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0.06884109973907471,
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0.011419152840971947,
0.08644900470972061,
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0.014703769236803055,
0.05004815012216568,
0.044450972229242325,
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0.02207542024552822,
0.037963610142469406,
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0.05477078631520271,
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0.052963096648454666,
0.013437328860163689,
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0.033182863146066666,
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0.05560622364282608,
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0.04568145051598549,
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0.06677651405334473,
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0.006411546841263771,
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0.15988150238990784,
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0.06536059826612473,
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0.04032193124294281,
0.059937119483947754,
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0.00917558092623949,
0.002593133132904768,
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0.056433532387018204,
0.03258218243718147,
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0.008007175289094448,
0.010946309193968773,
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0.03109726682305336,
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0.0061591872945427895,
0.16037264466285706,
0.014753878116607666,
0.03818318620324135,
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0.0024778309743851423,
0.05847898870706558,
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-0.028685064986348152,
1.944050557147146e-33,
0.018219904974102974,
0.1117936372756958,
0.013173243030905724,
-0.003065921366214752,
0.024844935163855553,
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0.03773205354809761,
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-0.019371023401618004,
-0.02542499266564846,
0.05609729513525963,
0.028441935777664185,
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0.028108786791563034,
0.0436130166053772,
-0.02487153373658657,
-0.05704788863658905,
-0.045811574906110764,
0.17984801530838013,
0.02378562092781067,
-0.003410759847611189,
-0.06263855844736099,
-0.028386540710926056,
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-0.04223031550645828,
0.0030300733633339405,
0.04361019283533096,
0.041423823684453964,
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0.003676022170111537,
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0.0025373545940965414,
0.048337824642658234,
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0.0409676618874073,
0.04966138303279877,
0.0932871550321579,
0.002217602916061878,
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0.016657544299960136,
0.0023025921545922756,
0.0062928893603384495,
0.0040670582093298435,
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0.020937573164701462,
0.027304036542773247,
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0.001441229018382728,
0.0024471604265272617,
0.046073805540800095,
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0.028851782903075218,
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0.016057025641202927,
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0.04568350687623024,
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0.04029000923037529,
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0.019085420295596123,
0.015061712823808193,
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0.0017736679874360561,
0.026180634275078773,
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0.049684714525938034,
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0.049423132091760635,
0.021013036370277405,
0.04130628705024719,
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0.09276291728019714,
0.022205224260687828,
0.0009133092826232314,
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0.02802450954914093,
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0.0800260454416275,
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0.039091143757104874,
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0.12128790467977524,
0.04078131169080734,
0.04420844465494156,
0.009646747261285782,
0.03114296682178974,
0.04203326255083084,
0.014136978425085545,
0.027239488437771797,
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0.017815865576267242,
0.08861559629440308,
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0.012290493585169315,
0.08757664263248444,
0.012636600062251091,
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0.0010591730242595077,
0.015401754528284073,
0.0042471750639379025,
0.048898205161094666,
0.0010087465634569526,
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0.003909136634320021,
0.0856001004576683,
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0.021655529737472534,
0.00591630581766367,
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0.02987869270145893,
0.005265872459858656,
0.09052736312150955,
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0.1256866455078125,
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0.01164920348674059,
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0.052877407521009445,
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0.0752403661608696,
0.01670597493648529,
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0.002238072920590639,
0.020162276923656464,
0.03974032402038574,
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0.03223245590925217,
0.05156002193689346,
0.03415648266673088,
0.0813956931233406,
0.002999193500727415,
0.057373449206352234,
0.07471416145563126,
0.1261296272277832,
0.06202316656708717,
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0.013753874227404594,
0.05211189016699791,
0.039492469280958176,
0.05238918960094452,
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0.07234209775924683,
0.037034135311841965,
-0.07087519764900208,
-0.028332598507404327,
0.0633527860045433,
0.025092817842960358,
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0.06241902709007263,
-0.03927972540259361,
-0.012750230729579926,
0.012695719487965107,
0.09490042924880981,
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0.0012539634481072426,
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0.022477295249700546,
-0.020995505154132843,
0.0004150430904701352,
0.022387085482478142,
0.031783875077962875,
0.021429872140288353,
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0.028829623013734818,
0.08316462486982346,
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0.005704901181161404,
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0.11687485873699188,
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0.061930373311042786,
0.06423211097717285,
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0.05559549853205681,
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0.10155099630355835,
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0.023211834952235222,
0.07046633958816528,
0.043927185237407684,
-0.027946751564741135,
0.0216583963483572,
0.08059848845005035,
0.037596337497234344,
0.040837131440639496,
-0.021187862381339073
] |
Table\t5.7\n\tprovides\ta\tguide\tto\tinterpreting\n\tWHtR\tby\tgender.\nTABLE\t5.7\nInterpretation\tof\tWaist-to-Height\tRatio\tby\tGender\nFemales\nMales\nWHtR\nWHtR\nInterpretation\n<\t0.35\n<\t0.35\nUnderweight;\tno\tincreased\trisk\n0.35-0.42\n0.35-0.43\nSlim;\tno\tincrease\trisk\n0.42-0.49\n0.43-0.53\nHealthy;\tno\tincreased\trisk\n0.49-0.54\n0.53-0.58\nOverweight;\tincreased/high\trisk | [
0.014260138384997845,
-0.012562213465571404,
0.00947700534015894,
0.005795396398752928,
-0.08567346632480621,
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0.040781356394290924,
0.06699323654174805,
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0.06160906329751015,
0.09021299332380295,
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0.009079746901988983,
0.005069855134934187,
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0.07289724797010422,
0.0021670835558325052,
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0.009750256314873695,
0.016271470114588737,
0.012912576086819172,
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0.0013380954042077065,
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0.047288618981838226,
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0.06531568616628647,
0.0004441038181539625,
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0.030161529779434204,
0.06858959048986435,
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0.018179379403591156,
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0.024015039205551147,
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0.004105997271835804,
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0.07537202537059784,
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0.029915951192378998,
0.016563361510634422,
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0.018584705889225006,
0.06979824602603912,
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0.03134078159928322,
0.06897341459989548,
0.0362524539232254,
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0.0233011431992054,
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0.009104907512664795,
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0.018929701298475266,
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0.009994663298130035,
0.046933677047491074,
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0.04923181235790253,
0.008718842640519142,
0.0953628197312355,
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0.024469811469316483,
0.04386134445667267,
0.021257109940052032,
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0.0196398813277483,
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0.0910269021987915,
0.026231369003653526,
0.04867008328437805,
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0.022658266127109528,
0.0477333627641201,
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1.4717872528386455e-33,
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0.008983364328742027,
0.02918403409421444,
0.0058249859139323235,
0.010722174309194088,
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0.057402439415454865,
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0.02358979545533657,
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0.10151396691799164,
0.045651454478502274,
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0.08215686678886414,
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0.02408885769546032,
0.02220006473362446,
0.06500422209501266,
0.006088955793529749,
0.005218769423663616,
0.011308882385492325,
0.04524986073374748,
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0.00979425385594368,
0.03073146753013134,
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0.49-0.54\n0.53-0.58\nOverweight;\tincreased/high\trisk\n0.54-0.58\n0.58-0.63\nObese;\tincreased/high\trisk\n>\t0.58\n>\t0.63\nVery\tobese;\n\tvery\thigh\trisk\nWHtR\n,\tWeight-to-height\tratio.\nAdapted\tfrom\tAshwell,\tM\t&\tGibson,\tS.\tWaist-to-height\tratio\tas\tan\tindicator\tof\t‘early\thealth\trisk’:\tsimpler\tand\tmore\tpredictive\tthan\tusing\ta\t‘matrix’ | [
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based\ton\tBMI\tand\twaist\tcircumference.\t\nBMJ\tOpen\n\t2016;\t6:e010159.\tdoi:\t10.1136/bmjopen-2015-010159.\nA\tsystematic\treview\tof\tevidence\ton\tuse\tof\tWHtR\ton\telderly\tpopulations\tshowed\tevidence\tthat\nWHtR\tis\n\tassociated\twith\tobesity\tand\tis\ta\tpredictor\tof\trisk\tfactors\tassociated\twith\tcardiovascular\ndisease,\tmetabolic\tsyndrome,\tand\tdiabetes\t( | [
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disease,\tmetabolic\tsyndrome,\tand\tdiabetes\t(\nCorrêa\tet\tal,\t2016\n;\t\nAshwell\tand\tGibson,\t2016\n).\tHowever,\nWHtR\tis\tnot\tidentified\tas\ta\trisk\tmarker\tin\tthe\tACC/AHA\tATP\t4.\nOther\tmethods\tof\tmeasuring\tbody\tcomposition\nDual-energy\tx-ray\tabsorptiometry\nDual-energy\tx-ray\tabsorptiometry\t(DXA)\n\tmeasures\tfat,\tbone\tmineral,\n\tand\tfat-free\tsoft\ttissue.\tThe | [
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measures\tfat,\tbone\tmineral,\n\tand\tfat-free\tsoft\ttissue.\tThe\nenergy\tsource\tin\tDXA\tis\tan\tx-ray\ttube\tthat\tcontains\tan\tenergy\tbeam.\tThe\tamount\tof\tenergy\tloss | [
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depends\ton\tthe\ttype\tof\ttissue\tthrough\twhich\tthe\tbeam\tpasses;\tthe\tresult\tcan\tbe\tused\tto\tmeasure\nmineral,\tfat,\tand\tlean\ttissue\tcompartments.\tDXA\tis\teasy\tto\tuse,\temits\tlow\tlevels\tof\tradiation,\tand\tis\navailable\tin\tthe\thospital\tsetting,\tmaking\tit\ta\tuseful\ttool.\tGenerally,\tit\n\tis\tfound\tto\tbe\ta\treliable | [
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] |
is\tfound\tto\tbe\ta\treliable\nmeasurement\tof\tpercentage\tbody\tfat;\thowever,\tthe\tpatient\tmust\tremain\tstill\tfor\tmore\tthan\ta\tfew\nminutes,\twhich\tmay\tbe\tdifficult\tfor\tolder\tadults\tand\tthose\tin\tchronic\tpain.\tMeasurements\tare\ninfluenced\tby\tthe\tthickness\tof\ttissues\tand\thydration\tstatus\t(\nPrado\tand\tHeymsfield,\t2014\n).\t\nFig.\t5.6\nillustrates\ta\tDXA\tscan.\nFIG.\t5.6 | [
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FIG.\t5.7\nThe\tBOD-POD\tmeasures\tbody\tfat\tand\tfat-free\tmass.\n\tSource:\t\n(Courtesy\tCOSMED\tUSA,\tInc.,\tConcord,\tCA.)\nIndirect\tcalorimetry\nIndirect\tcalorimetry\tis\tthe\tmost\taccurate\tmethod\tfor\testimating\tenergy\texpenditure\tby\tmeasuring\ninspired\tand\texpired\toxygen\tand\tcarbon\tdioxide.\tTotal\tenergy\trequirements\t(TEE)\tare\tcalculated | [
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history\tto\taccurately\tmake\none\tor\tmore\tnutrition\tdiagnoses.\tThe\t\nInternational\tDietetics\t&\tNutrition\tTerminology\tReference\nManual\n\t(IDNT)\t(\nAND,\t2018\n)\tdefines\tnutrition-focused\tphysical\texamination\tas\t“findings\tfrom\tan\nevaluation\tof\tbody\tsystems,\tmuscle\tand\tsubcutaneous\tfat\twasting,\toral\thealth,\tsuck,\tswallow/breathe | [
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ability,\tappetite\tand\taffect.”\tUnlike\ta\tcomprehensive\tclinical\texamination\tthat\n\treviews\tall\tbody\nsystems,\tNFPE\tis\ta\tfocused\tassessment\tthat\taddresses\tspecific\tsigns\tand\tsymptoms\tby\treviewing\nselected\tbody\tsystems.\nApproach\nA\tsystems\tapproach\tis\tused\twhen\tperforming\tthe\tNFPE,\twhich\tshould\tbe\tconducted\tin\tan\torganized, | [
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logical\tway\tto\tensure\tefficiency\tand\tthoroughness\t(\nLitchford,\t2013\n).\tBody\tsystems\tinclude\tthe\nfollowing:\n•\t\nGeneral\tappearance\n•\t\nVital\tsigns\n•\t\nSkin\n•\t\nNails\n•\t\nHair\n•\t\nHead\n•\t\nEyes\n•\t\nNose\n•\t\nMouth\n•\t\nNeck/chest\n•\t\nAbdomen\n•\t\nMusculoskeletal | [
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] |
Equipment\nThe\textent\tof\tthe\tNFPE\tdictates\tthe\tnecessary\tequipment.\tAny\tor\tall\tof\tthe\tfollowing\tmay\tbe\tused:\nexamination\tgloves,\ta\tstethoscope,\ta\tpenlight\tor\tflashlight,\ta\ttongue\tdepressor,\tscales,\tcalipers,\ta\ntape\tmeasure,\ta\tblood\tpressure\tcuff,\ta\twatch\twith\ta\tsecond\thand,\tand\tdynamometer\tto\tmeasure\nhand\tgrip\tstrength. | [
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] |
hand\tgrip\tstrength.\nExamination\ttechniques\tand\tfindings\nFour\tbasic\tphysical\texamination\ttechniques\tare\tused\tduring\tthe\tNFPE.\tThese\ttechniques\tinclude\ninspection,\tpalpation,\tpercussion,\tand\tauscultation\t(\nTable\t5.8\n).\t\nAppendix\t11\n\tdiscusses\tNFPE\tin\tmore\ndetail.\nTABLE\t5.8\nPhysical\tExamination\tTechniques\nTechnique\nDescription\nInspection | [
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Physical\tExamination\tTechniques\nTechnique\nDescription\nInspection\nGeneral\tobservation\tthat\tprogresses\tto\ta\tmore\n\tfocused\tobservation\tusing\tthe\tsenses\tof\tsight,\nsmell,\tand\thearing;\tnote\tappearance,\tmood,\tbehavior,\tmovement,\tfacial\texpressions;\tmost\nfrequently\tused\ttechnique\nPalpation | [
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Nutrition\tfocused\tphysical\tassessment:\tmaking\tclinical\tconnections\n,\tGreensboro,\tNC,\t2013,\tCASE\tSoftware\t&\tBooks.\nInterpretation\tof\tdata\n\tcollected\tin\teach\tcomponent\tof\tan\tNFPE\trequires\tcritical\tthinking\tskills\tand\nthe\tfollowing\tsteps\tin\tclinical\treasoning:\n•\t\nIdentify\tabnormal\tfindings\tor\tsymptoms.\n•\t\nLocalize\tthe\tfindings\tanatomically.\n• | [
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•\t\nLocalize\tthe\tfindings\tanatomically.\n•\t\nInterpret\tfindings\tin\tterms\tof\tprobable\tprocess.\n•\t\nMake\ta\thypothesis\tabout\tthe\tnature\tof\tthe\tpatient’s\tproblem.\n•\t\nTest\tthe\thypothesis\tby\tcollaborating\twith\tother\tmedical\tprofessionals\tand\n\testablish\ta\nworking\tnutrition\tdiagnosis.\n• | [
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establish\ta\nworking\tnutrition\tdiagnosis.\n•\t\nDevelop\ta\tplan\tagreeable\tto\tthe\tpatient\tfollowing\tall\tthe\tsteps\tof\tthe\tNCP\tmodel\t(\nBickley,\n2017\n)\t(see\t\nChapter\t9\n).\nGuidelines\tfor\tassessing\tmalnutrition\tin\tchildren\nDefinitions\tand\tguidelines\tto\tidentify\tmalnutrition\tin\tchildren\tare\tevolving.\tPediatric\tmalnutrition\tis | [
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behavioral\tfactor\t(\nMehta\tet\tal,\t2013\n).\tSpecific\tparameters\tfor\tdetermining\tpediatric\tundernutrition\nand\tmalnutrition\tare\tbeing\tstandardized\t(\nBecker\tet\tal,\t2015\n).\nGuidelines\n\tfor\tassessing\tmalnutrition\tin\tadults\nThe\tAcademy\tand\tthe\tASPEN\tConsensus\tStatement:\tCharacteristics\tRecommended\tfor\tthe | [
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FIG.\t5.8\nCause-based\tmalnutrition.\n\tSource:\t\n(Adapted\tfrom\tWhite\tJV\tet\tal:\tConsensus\tstatement\tof\tthe\tAcademy\tof\tNutrition\nand\tDietetics/American\tSociety\tfor\tParenteral\tand\tEnteral\tNutrition:\tcharacteristics\trecommended\tfor\tthe\tidentification\tand\ndocumentation\tof\tadult\tmalnutrition\t(undernutrition),\t\nJ\tAcad\tNutr\tDiet\n\t112(5):730,\t2012.) | [
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J\tAcad\tNutr\tDiet\n\t112(5):730,\t2012.)\nNo\tsingle\tparameter\tdefines\tmalnutrition.\tThe\tConsensus\n\tguidelines\tidentify\tsix\tcharacteristics\tof\nmalnutrition.\tFrom\tthese,\tthe\tclinician\tmust\tidentify\ta\tminimum\tof\ttwo\tcharacteristics\tthat\trelate\tto\nthe\tcontext\tof\tthe\tconcurrent\tmedical\tcondition\tfor\ta\tnutrition\tdiagnosis\tof\tmalnutrition.\tThe | [
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characteristics\tof\tnonsevere\tand\tsevere\tmalnutrition\tare\tnoted\tin\t\nTable\t5.9\n.\nTABLE\t5.9\nCharacteristics\tof\tAdult\tMalnutrition\nACUTE\tILLNESS\tOR\tINJURY\nCHRONIC\tILLNESS\nSOCIAL\tOR\tENVIRONMENTAL\nCIRCUMSTANCES\nNonsevere\nSevere\nNonsevere\nSevere\nNonsevere\nSevere\nInterpretation\tof\tWeight\tLoss\tfor\tMalnutrition\tby\tCause\n1-2%\tin\t1\twk\n>2%\tin\t1\twk\n5%\tin\t1\twk | [
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1-2%\tin\t1\twk\n>2%\tin\t1\twk\n5%\tin\t1\twk\n>5%\tin\t1\twk\n>5%\tin\t1\twk\n>5%\tin\t1\twk\n5%\tin\t1\tmo\n>5%\tin\t1\tmo\n7.5%\n\tin\t3\nmo\n>7.5%\tin\t3\tmo\n>7.5%\tin\t3\nmo\n>7.5%\tin\t3\tmo\n7.5%\tin\t3\nmo\n>7.5%\tin\t3\tmo\n10%\tin\t6\tmo\n>10%\tin\t6\tmo\n>10%\tin\t6\nmo\n>10%\tin\t6\tmo\n20%\tin\t1\tyr\n>20%\tin\t1\tyr\n>20%\tin\t1\nyr\n>20%\tin\t1\tyr\nInterpretation\tof\tReduced\tEnergy\tIntake\tfor\tMalnutrition\tby\tCause | [
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Interpretation\tof\tReduced\tEnergy\tIntake\tfor\tMalnutrition\tby\tCause\nFor\t>7\tdays\n<\t75%\tof\nestimated\nenergy\nneeds\nFor\t>\tor\t=\tto\n5\tdays\n<\tor\t=\tto\t50%\nof\nestimated\nenergy\nneeds\nFor\t>\tor\t=\nto\t1\tmo\n<75%\tof\nestimated\nenergy\nneeds\nFor\t>\tor\t=\tto\n1\tmo\n<\tor\t=\tto\t75%\nof\nestimated\nenergy\nneeds\nFor\t>\tor\t=\nto\t3\tmo\n<75%\tof\nestimated\nenergy\nneeds\nFor\t>\tor\t=\tto\n1\tmo | [
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