Nutrition Assessment and Anthropometry
Core concepts
Assessment integrates the nutrition-focused physical exam (NFPE), anthropometry, biochemical data, clinical history, and dietary intake. Know how to compute and interpret BMI (kg/m²), ideal and adjusted body weight, percent weight change over time, and waist circumference risk thresholds. Understand that unintended weight loss >5% in 1 month or >10% in 6 months signals malnutrition risk. Be able to apply the GLIM criteria (phenotypic: weight loss, low BMI, reduced muscle mass; etiologic: reduced intake/assimilation, inflammation) and to distinguish starvation-related from disease-related malnutrition. Recognize NFPE signs: temporal wasting, thenar/interosseous muscle loss, edema, poor wound healing, and micronutrient deficiency signs (e.g., glossitis, cheilosis, koilonychia). Interpret albumin and prealbumin cautiously-they are negative acute-phase reactants, not pure nutrition markers.
Traps
Questions test whether you know that albumin falls with inflammation and is a poor short-term indicator. Watch for unit errors (cm vs m in BMI), and for percent weight loss calculated against usual, not current, weight. Do not confuse BMI cutoffs for Asian populations or for older adults.
Worked example
Usual weight 80 kg, current 72 kg: loss = 8 kg; percent = 8/80 × 100 = 10%. If this occurred over 3 months, it meets a GLIM phenotypic criterion for severe weight loss, and if reduced intake or inflammation is present, malnutrition can be diagnosed.
Rule of thumb
Always calculate BMI in meters squared, and percent weight change against usual body weight.