Overeating contributes to chronic disorders and diseases such as cancer, hypertension, obesity, diabetes mellitus and coronary heart disease. Dietary measures are needed in many hereditary metabolic disorders such as galactosemia or phenylketonuria.
Malnutrition often impaired health status, regardless of whether a person is sick or not. Also, certain diseases such. B. cause malabsorption, nutritional deficiencies. In addition are in many patients such. As in the elderly, who were admitted on an emergency basis, unexpected nutrient deficiencies before, in need of treatment. In many medical centers are interdisciplinary nutritional teams of doctors, nurses, nutritionists and pharmacists who aid the clinician thereby prevent hidden nutritional deficiencies to diagnose nutritional deficiencies and treat. Overeating contributes to chronic disorders and diseases such as cancer, hypertension, obesity, diabetes mellitus and coronary heart disease. Dietary measures are needed in many hereditary metabolic disorders such as galactosemia or phenylketonuria. Nutritional assessments to the indications for the study of the diet include: unwanted body weight or body composition suspected certain defects or oxizitäten of essential nutrients in young children and infants, inhibited (s) growth or development. Nutritional status should be routinely assessed in clinical testing infants and children Elderly people who take multiple medications people with psychiatric disorders people with systemic diseases that last longer than a few days An assessment of the nutritional status includes the diet history, physical examination and the interpretation of tests. In cases of suspected malnutrition laboratory tests (eg., Albumin levels), and tests are carried out on a verrringerte hypersensitivity of the skin. An analysis of body fat (z. B. skin fold measurement, bioelectrical impedance analysis) is carried out in order to determine the percentage of body fat and to evaluate a obesity. To capture the diet history facts about diet, weight changes and risk factors are asked for dietary deficiencies and body systems in detail studied (see Table: Symptoms and signs of deficiency). A dietitian can inform detailed about the diet of a patient. Similar information is collected usually have a list of consumed food and groceries in a 24-hour interval and a food questionnaire. Using a food diary can record all food that takes a man to himself. There is the most accurate form of documentation that the patient outweighs all consumed in an ad libitum diet foods and record the data. Symptoms and signs of deficiency area / system symptoms or signs General appearance Lack wasting energy appearance rash many vitamins, zinc, essential fatty acids rash in sunlight exposure niacin (pellagra) fast le hematoma vitamin C or vitamin K hair and nails thinning hair or hair loss protein premature graying hair is selenium spoon nails Iron Eyes Night blindness Vitamin A Keratomalacia (dehydration and corneal opacity) Vitamin A Cheilosis mouth and glossitis riboflavin, niacin, pyridoxine, iron bleeding gums vitamin C, riboflavin extremity edema protein nervous system paresthesia or numbness in a stocking-glove distribution thiamine (beriberi) tetany calcium , Magnesium Cognitive and sensory deficits thiamine, niacin, pyridoxine, vitamin B12 dementia thiamine, niacin, vitamin B12 posture and musculoskeletal muscle breakdown protein bone deformities (eg. As bow legs, knock knees, scoliosis) Vitamin D, calcium delicate bone or joint pain Vitamin D Vitamin C turgors gastrointestinal tract diarrhea protein, niacin, folic acid, vitamin B12 diarrhea and dysgeusia zinc dysphagia or odynophagia (due Plummer-Vinson syndrome ) iron endocrine system thyroid enlargement iodine should always a complete physical examination, incl. the determination of height, weight and body fat distribution are performed. The body mass index (BMI, weight in kg / height in m2), of the ideal weight according to the body size (see Table: body mass index (BMI)), is more accurate than the size and weight tables. Normal values ??were established (Physical growth of infants and children) for the growth and weight gain of infants, children and adolescents. Body mass index (BMI) BMI weight category: ) Normal * (18.5-24) overweight (25-29) Obese (30-34) Obese (35-39) Extremely Obese (40-47) Extremely Obese (48- 54) size (cm) body weight (kg) 150-154 44-58 58-70 70-82 81-94 93-113 111-131 155-159 47-61 62-74 75-87 87-100 99-120 119-138 160-164 50-65 66-79 79-93 93-106 105-128 127-147 165-169 54- 70 70-84 85-99 98-113 112-136 135-156 170-174 87-74 75-89 90-105 105-120 119-145 143-166 175-179 60-78 79-95 95-110 110-127 126-154 152- 175180-184 64-83 84-100 100-117 117-134 134-161 160-185 185-189 67-87 88-105 106-124 124-141 141-170 170-196 190 71-90 93-108 112-127 130 -145149-175 179-201 * A BMI below the specified values ??indicates underweight. Calculations are in metric units (kg, m), but the table shows for US readers in inches and pounds. Clinical Calculator: Body Mass Index (Quetelet’s index) The distribution of body fat is important. Disproportionate obesity on the trunk, d. H. a ratio of waist to hip circumference> 0.8 is more commonly associated with cardiovascular and cerebrovascular disease, hypertension and diabetes mellitus than fat tissue, which is placed elsewhere. The measurement of waist circumference in patients with a BMI of <35 helps determine whether a body obesity is present and to predict the risk for diabetes, hypertension, hypercholesterolemia, and cardiovascular disease. The risk increases if the waist circumference> 102 cm (> 40 inches) in men and> 88 cm (> 35 inches) in women.