Center for Human Nutrition

Medical Nutrition Syllabus

Guide to Healthy Diet and Lifestyle

Exercise Guidelines

Managing Obesity

Exercise Prescription

Medicine and Surgery Nutrition Assessment Checklist

Pediatric Nutrition Assessment Checklist

Adolescent Nutrition Assessment Checklist
Syllabus Menu: | Dietary Assessment | Weight Assessment | Dietary Recommendations | Nutritional Deficiencies | Nutrition During Lifecyle | Nutrition in Pathological Conditions | Vegetarianism | [Popular Diets | References |

 
Clinical Signs & Symptoms of Nutritional Deficiencies

Physical Examination: Certain risk factors and signs of nutrient deficiency or excess can be identified during the physical examination. Any one sign is rarely diagnostic; the more signs present the more likely they reflect a malnourished individual.

Hair: dull, dry, sparse, shedding

Eyes: cloudy, pale, dry, red, dull

Lips: swollen, red, cracks at sides

Gums: bleeding, abnormally red, swollen

Teeth: dental enamel erosion in bulimia due to induced vomiting

Tongue: swollen, red, fissured, glossitis, atrophic lingual papillae due to deficiency of riboflavin, niacin, folate, vitamin B-12, protein or iron

Skin: dry, flaky, hyperpigmented, decubiti present, decreased skin turgor, poor wound healing due to deficiency of protein, vitamin C, zinc; xanthomas due to increased serum lipids

Nails: spoon-shaped, brittle, and ridged

Face: dark skin, scaling skin, pallor

Hands: smooth areas on backs of fingers and nails in bulimia from inducing vomiting

Lower extremities: edematous

Muscular: wasted, weak, tender, xanthomas (tendon, planar, palmar) in hyperlipidemia

Neurologic: apathy, lethargy, disoriented, memory loss, and paresthesia

Laboratory Tests: Many lab tests can provide useful information on patientsí nutritional status along with information on their medical status.

  • Red Blood Cell Parameters: hematocrit and hemoglobin (low values indicate anemia), low mean corpuscular volume (MCV) or microcytosis-- iron, copper, pyridoxine deficiency, high MCV or macrocytosis - folate, vitamin B12 deficiency.
  • White Blood Cell Count: neutropenia is often seen in deficiency states.
  • Serum Lipid Levels: total cholesterol >200 mg/dl, HDL <35 mg/dl, LDL >130 mg/dl.
  • Vitamin levels: folate and vitamin B12 can be helpful.
  • Creatinine-height index (estimate skeletal muscle mass).
  • Visceral proteins: serum albumin, serum transferrin etc.
  • Blood Urea Nitrogen (BUN).
  • Urinary Urea Nitrogen (UNN).