Issues in Nutrition: Nutritional Assessment of Adults

The assessment of nutritional status in adults should begin with a complete history, including intake of fruits and vegetables, sources of fat, and added sugar (eg, sugar-sweetened beverages). The history should include social factors that may impede a patient's ability to obtain food, as well as any factors that might interfere with preparing, chewing, and digesting food and absorbing nutrients. The physical examination should include measurement of height and weight and calculation of body mass index. It also may include measurements of waist circumference and waist to hip ratio, and an evaluation of strength. Laboratory evaluation should include measurement of albumin, prealbumin, and other markers of total body protein stores. No biomarker is completely sensitive or specific. With a range of dietary patterns, it is possible for nutritional gaps specific to those patterns to develop. Identification of a single nutrient deficiency typically reflects an overall weakness in the diet. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets have the most evidence to support them as healthy diets.