Current techniques of nutritional assessment.

This article has dealt with techniques of nutritional assessment as currently utilized in the hospital setting. Although the techniques are easily mastered and abundant data have been collected, we are only slightly closer to achieving an accurate and clinically meaningful nutritional assessment. Interpretation of data is hampered by reliance on tables of "norms" and by the questionable validity of relating individual tests to the whole patient. The interest stimulated in nutrition by widespread application of these assessment techniques, however, has resulted in a burst of new investigative efforts. Determination of body composition by total body neutron activation and isotope dilution during various states of nutrition, isotope studies of substrate utilization, and evaluation of body function relative to composition are all exciting areas of future investigation. Until an accurate comprehensive technique of nutritional assessment is available, emphasis must be placed on obtaining as much data as possible from the dietary and clinical history, physical examination, and anthropometric and laboratory measurements, with great reliance on clinical impression and judgement. At the current state of the art, in addition to the history and physical examination, we propose as a minimum that a nutritional assessment consist of current weight and recording of recent weight change, determination of serum albumin, transferrin, TLC, and testing for DTHR to common skin test antigens, and an evaluation of muscle function.