Core indicators of nutritional state for difficult-to-sample populations.

Previous expert working groups have concluded that common descriptors and measurements are needed for all types of population groups to provide improved and expanded coverage and comparable and compatible data among surveys monitoring the nutritional and dietary status of the U.S. population. This report summarizes the discussions of an ad hoc Expert Panel charged with identifying core indicators to assess the nutritional status of difficult-to-sample populations. Members of the Expert Panel had wide research experience including survey design, food security, food consumption, nutritional status, health-related conditions associated with nutritional status, and nutrition and public policy. The varied backgrounds of the Panel members led to consideration of the concept of core indicators of nutritional status from a broad perspective. Early in their discussions the Expert Panel recognized that public health officials and policymakers use information on nutritional status for the purposes of problem identification, program planning and resource direction, and program and policy evaluation. This recognition raised several issues which formed the conceptual framework for subsequent discussions, study conclusions, and research recommendations. These issues centered on the following concepts: the purpose for which data are used determines the suitability of indicators; the scope of information required varies for the purposes identified above; a broad range of indicators is needed to supply information useful for public policy decisions on nutrition; that is, assessment of the nutritional status of populations by measurement of dietary intakes of nutrients and anthropometric, biochemical, and clinical indices can provide only a portion of the information needed for these purposes in the United States; nutritional problems in the U.S. general population may signal some, but not all, anticipated nutritional concerns for difficult-to-sample populations; and, adequate coverage and suitable sampling methods are overriding concerns for obtaining interpretable data and appear to be a larger issue than suitable measures for nutritional assessment in the case of difficult-to-sample populations. Guided by consideration of these issues, the Expert Panel recognized that they could not provide a comprehensive design for the evaluation of nutritional status for all difficult-to-sample populations that would be appropriate for all public health and policy purposes. Therefore, the Expert Panel concentrated their discussions on enumeration of the various issues that must be considered in planning any effort to evaluate the nutritional concerns for such populations.(ABSTRACT TRUNCATED AT 400 WORDS)