CM5.{2,4,9,11} | CM5.{2,4,9,11} | Nutritional Assessment and Diet Planning — Summary & Reflection

KEY TAKEAWAYS

Nutritional assessment uses the ABCD framework — Anthropometric (BMI using Indian cut-offs: ≥23 overweight; MUAC for children: <11.5 cm SAM, 11.5-12.4 cm MAM), Biochemical (haemoglobin, serum ferritin, serum albumin), Clinical (pallor, Bitot's spots, goitre, oedema), and Dietary (24-hour recall, dietary diversity score) — to identify nutritional problems objectively. Diet planning follows a five-step framework: assess needs → set targets (ICMR-NIN 2020 RDA: protein 0.83 g/kg/day; energy ~1660 kcal/day sedentary woman) → select food groups → plan meal pattern using locally available foods → validate against targets. Protein planning across dietary patterns uses the same RDA (0.83 g/kg/day) regardless of dietary preference; vegetarians achieve adequacy through complementary protein combining (rice + dal covers lysine-methionine gap). Millets (ragi for calcium, bajra for iron/zinc) are cost-effective tools for rural diet planning. Monitoring uses repeat anthropometry, biochemical re-testing, and dietary diversity scores; community surveillance uses POSHAN Tracker and ICDS weighing records.

REFLECT

Consider a family you might encounter in a community medicine posting: a 25-year-old vegetarian woman (55 kg, second trimester pregnancy), her 4-year-old child (weight 12 kg, MUAC 13 cm), and her 60-year-old mother-in-law (BMI 26.5, complaining of knee pain). Using the ABCD framework and the five-step diet planning process, identify one nutritional concern for each family member and propose one specific, locally feasible dietary modification for each. How would you prioritise your counselling time if you had only 10 minutes for the whole family?