Nutritional Assessment and Its Comparison Between Obese and Non
Nutritional Assessment and Its Comparison Between Obese and Non
Nutritional Assessment and Its Comparison Between Obese and Non
ON
NUTRITIONAL ASSESSMENT AND ITS
COMPARISON BETWEEN OBESE AND NONOBESE FEMALE
A case study on
STUDENTS OF GNE
Chapter I
INTRODUCTION
The original term was used by a sub-committee of the League of Nations (1932) referring to a
set of medical tasks to determine the nutritional status of a population (Gibson, 2005). After
1976 (Bistrian & Blackburn et al), it became a standardized, hospital-based set of tools to
predict nutrition and health outcomes in individual patients with post-op complications, trauma
or malnutrition. In 1996, Theresa Schneider RD decided to take assessment tools out of the
hospital to assess the health of athletes, those with chronic diseases and corporate executives.
Today a nutrition assessment includes computerized food intake analysis, clinical nutrition
body composition assessment (bioelectrical impedance), laboratory blood test results if
applicable, anthropometrics, review of medications, lifestyle and fitness indicators. Whether
your goal is to improve your athletic performance, or you want to make a nutrition lifestyle
choice or you want to better manage your medical condition nutrition assessment can help you
succeed.
How much food in a day is too much? Am I overweight? What is my body fat content? Am I
better off with proteins (Atkins diet) than carbs (Mediterranean diet)? No easy answers to
these questions for many of us.
Even if you feel good and you are happy with the way you look you should still consider the
long term impact of an improper caloric balance or carbs vs. protein balance to your health.
The nutritional and medical experts defined few indicators that assess the physical body
from an energetic perspective. Further on, the experts correlated these indicators with certain
health risk factors. For laymen though these indicators are translated in real life information
as: food daily needs, body weight and body fat assessment or even decisions like pasta or
stake for dinner.
The nutritional indicators should be regarded as a starting point. The human body is more
complex than a simple energy exchange machine of calories in, calories burned type. There
are subtle mind related factors for example that are not accounted for in the above indicators.
And the mind regulates at the subconscious level the metabolism including the calories
burned.
It is also important to emphasize that these indicators are statistical in nature therefore may
not be representative for certain individuals. Think of them as a golden mean that provides a
ballpark figure of your nutritional state .
The goal of nutritional assessment in childhood is to prevent nutritional disorders and the
increased morbidity and mortality that accompany them. To meet this goal, pediatric clinicians
must know the risk factors for obesity and malnutrition and must understand the normal and
abnormal patterns of growth and the changes in body composition during childhood and
adolescence. In addition, they must be able to accurately perform and interpret the results of
the nutritional evaluation.
Nutritional assessment is the quantitative evaluation of nutritional status. A comprehensive
nutritional assessment has five components:
Physical examination
Laboratory tests
Krause's Food, Nutrition, and Diet Therapy is a classic textbook in the field of nutrition and
diet therapy, recognizing the increasing importance of nutrition in achieving and maintaining
optimal health and fitness and as a component of complete and effective healthcare.
Originated by Marie Krause Mendelson in 1952, this text has become a universally
recognized and authoritative text for nutrition and diet therapy students and practicing
registered dietitians. As always, with its extensive appendices, tables, illustrations, figures,
and clinical insight boxes providing practical hands-on procedures and clinical tools, it
continues to be the textbook that can accompany the graduating student into clinical practice
as a valuable reference source. As with previous editions, all material has been updated to
reflect the most current information available, and a new chapter titled Nutrition and
Genetics has been added. The text is edited by two leading experts in the field of nutrition
and written by close to 50 contributors, all experts in their specialty fields. Forty-five
chapters, divided into five units, provide a wealth of information on nutrition basics, nutrition
through the life cycle, nutrition care, nutrition for health and fitness, and medical nutrition
therapy.
So you determined if you are or not overweight what is your body fat and how many calories
you need every day.
To assess the nutritional status of obese and non-obese female students of GNE
COLLEGE,
To compare the obese and non-obese female students of GNE COLLEGE in relation
to nutritional Status.
Delimitations
The study was further delimited to students whos age ranging between 18 to 28 years.
Limitations
Different ways of living, socio-economic conditions, nature of activity, daily routine &
habits of different Female students of GNE COLLEGE which were not under the control of
research scholar were considered as a limitation of the study.
The educational and socio economic back ground, which could have affected the
ability of the subjects in answering the questionnaire would not be taken into consideration in
analyzing the results. This was another limitation of the study.
The questionnaire in itself has its own limitations. As such any biasopinion that may be
given by the subject in the form of responses that affect the result of the study might be
considered as limitation of the study.
Hypothesis
It was hypothesized that there might have been significant differences in nutritional status
between obese and non-obese female students of Banaras Hindu University.
Definition and Explanation of theTerms Nutritional Assessment
The definition of Nutritional Assessment is: A structured way to establish nutritional status
and energy-requirements by objective measurements and whereby, completed with objective
parameters and in relation to specific disease-indications, an adequate (nutritional-) treatment
can be developed for the patient. All this happens preferably in a multidisciplinary setting.
Nutrition assessment is an evaluation and measurement of nutritional variables in order to
assess the level of nutrition or the nutritional status of the individual. Nutrition surveys may
be used in making the assessment.
Obese
Obese the word came out from obesity and Obesity is a medical condition in which excess
body fat has accumulated to the extent that it may have an adverse effect on health, leading to
The findings of the study may be used to assess the nutritional status of obese and nonobese female students of Banaras Hindu University.
2.
The findings of the study may be used to highlight the differences between obese and
non-obese female students of BHU in relation to nutritional assessment.
3. The study will highlight the diet, calorie control, fat/cholesterol control, and sodium/salt
control in obese and non-obese female students of Banaras Hindu University.
4. The findings of the study will provide a guide-line to the future research investigators in
nutritional assessment and nutritional sciences to conduct further research in this field.
5. The results of the present study will add to the existing body of knowledge in the respective
areas.
Guest J, & Bilgin A, (2010) In Western countries the increasing prevalence of obesity in
young people is a major public health concern. While the focus has been on reducing obesity,
paradoxically the success of these campaigns may result in unhealthy nutritional practices.
The aim of this study was to investigate the use and impact of weight control techniques on
the health of adolescent females. Using Analysis of Variance we compared physiological and
biochemical markers of health against responses to a modified, Schools Physical Activity and
Nutrition Survey (SPANS) in 482 adolescent females (14-17 yrs) from secondary schools in
the northern Sydney and Central Coast regions of New South Wales, Australia. Participants
who 'often' used weight control methods had, on average, a healthy BMI of 22.5 (SD=3.7).
However, comparison of blood derived markers between participants who 'never',
'occasionally' or 'often' used weight reduction techniques showed that, those who 'often' used
weight
control methods had significantly lower haemoglobin (p<0.05), alkaline phosphatase
(p<0.001), bilirubin (p<0.05), albumin (p<0.05), total protein (p<0.05), and calcium (p<0.05),
but higher blood levels of creatinine (p<0.05) and potassium (p<0.05). These data suggest that
the use of common weight control techniques by healthy weight adolescent females can
produce a metabolically divergent group whose biochemical markers are consistent with
subtle levels of chronic under-nutrition.
Darcy L. Johannsen, & James P. DeLany (2008) Physical activity (PA) is known to decline
with age; however, there is a paucity of data on activity in persons who are in their nineties and
beyond. We used objective and reliable methods to measure PA in nonagenarians (90 yr; n =
98) and hypothesized that activity would be similar to that of aged (6074 yr; n = 58) subjects
but less than in young (2034 yr; n = 53) volunteers. Total energy expenditure (TEE) was
measured by doubly labeled water over 14 days and resting metabolic rate (RMR) by indirect
calorimetry. Measures of PA included activity energy expenditure adjusted for body
composition, TEE adjusted for RMR, physical activity level (PAL), and activity over 14 days
by accelerometry expressed as average daily durations of light and moderate activity. RMR and
TEE were lower with increasing age group (P < 0.01); however, RMR was not different
between aged and nonagenarian subjects after adjusting for fat-free mass, fat mass, and sex.
Nonagenarians had a lower PAL and were more sedentary than the aged and young groups (P <
0.01); however, the nonagenarians who were more active on a daily basis walked further
during a timed test, indicating higher physical functionality. For all measures of activity, no
differences were found between young and aged volunteers. PA was markedly lower in
nonagenarians compared with
young and aged adults. Interestingly, PA was similar between young volunteers and those who
were in their 60s and 70s, likely due to the sedentary nature of our society, particularly in
young adults.
Feifei Wang, & Tim McDonald (2005) to examine the influence of physical activity (PA) and
BMI on health care utilization and costs among Medicare retirees. This cross-sectional study
was based on 42,520 Medicare retirees in a U.S.-wide manufacturing corporation who
participated in indemnity/preferred provider and one health risk appraisal during the years
2001 and 2002. Participants were assigned into one of the three weight groups: normal weight,
overweight, and obese. PA behavior was classified into three levels: sedentary (0 time/wk),
moderately active (1 to 3 times/wk), and very active (4+ times/wk). Generalized linear models
revealed that the moderately active retirees had $1456, $1731, and $1177 lower total health
care charges than their sedentary counterparts in the normal-weight, overweight, and obese
groups, respectively (p < 0.01). The very active retirees had $1823, $581, and $1379 lower
costs than the moderately active retirees. Health care utilization and specific costs showed
similar trends with PA levels for all BMI groups. The total health care charges were lower with
higher PA level for all age groups (p < 0.01). Regular PA has strong dose-response effects on
both health care utilization and costs for overweight/obese as well as normal-weight people.
Promoting active lifestyle in this Medicare population, especially overweight and obese
groups, could potentially improve their well-being and save a substantial amount of health care
expenditures. Because those Medicare retirees are hard to reach in general, more creative
approaches should be launched to address their needs and interests as well as help reduce the
usage of health care system.
Jacques Rigoaf (2001) In recent years, improvements in care have significantly improved
survival in preterm and, particularly, the very low birth weight infant (VLBW). While
immediate survival can be directly related to pulmonary maturity, several studies stress the
importance of timely and adequate nutrition in these high-risk infants on a short- and long-term
[1]. Yet, nutritional support remains a very controversial issue in these high-risk infants. Early
provision of adequate intakes may be limited by clinical instability and immaturity. At the same
time, nutritional requirements and methods of nutritional assessment are not well defined. The
aim of this paper is to outline some of the methods used during nutritional assessment in
preterm infants with special reference to the measurement of body composition.
b.
c.
d.
Criterion Measures
The following criterion was adopted for the present study:
To Assess Obesity:
1.
Prudent Diet was assessed by the total scores in Prudent Diet Questionnaire.
2.
Calorie Control was assessed by the total scores in Calorie Control Questionnaire.
3.
4.
response to each statement truthfully as soon as possible. The questionnaires were taken back
after duly completed. Thorough screening was done to check that no question was left
unanswered. The scoring was done for each variable according to the instructions given in the
respective manual.
Collection of Data
With the help of the questionnaires related to nutritional assessment necessary data was
collected. Data was collected with regard to various nutritional aspects from 50 female
students (25 obese & 25 non-obese) in two consecutive days at their respective institution.
Statistical Technique
The data was analyzed by applying Descriptive Statistic & t test in order to assess and
compare the nutritional assessment between obese and non obese female students of BHU.
The level of significance was set at 0.05.
Level of Significance
The level of significance to check the t ratio was set at 0.05 level which was considered
appropriate for the purpose of the study.
Table-1
Descriptive Statistics of Obese Female Students of Banaras Hindu
University
Prudent
Diet Questionnaire
Mean
14.4
Calorie Control
Questionnaire
Fat/Cholesterol
Control
Questionnaire
Mean
Mean
9.8
11.44
Sodium/Salt
Control
Questionnaire
Mean
6.8
Standard
Deviation
Kurtosis
Skewness
Range
Minimum
Maximum
Standard
Standard
Standard
2.140872 Deviation 3.122499 Deviation 3.686462 Deviation 1.607275
-0.97124 Kurtosis -1.30604 Kurtosis -1.13024 Kurtosis 3.39582
-0.18278 Skewness 0.496272 Skewness 0.21546 Skewness 1.596877
7
Range
9
Range
11
Range
7
11
Minimum
6
Minimum
6
Minimum
5
18
Maximum 15
Maximum
17
Maximum
12
It is evident from table - 1 that mean and standard deviation scores of obese female students of
BHU in relation to prudent diet questionnaire, Calorie Control Questionnaire, Fat/Cholesterol
Control Questionnaire, and Sodium/Salt Control Questionnaire have been found 14.4, 9.8,
11.44, & 6.8 and 2.1, 3.1, 3.6 & 3.3 respectively whereas range of scores was found 7, 9, 11, &
7 respectively.
Table-2
Descriptive Statistics of Non-Obese Female Students of Banaras Hindu
University
Prudent
Diet Questionnaire
Calorie Control
Questionnaire
Fat/Cholesterol
Control
Questionnaire
Mean
14.92
Mean
10.24
Mean
9.72
Standard
Standard
Standard
Deviation 1.956187 Deviation 1.832121 Deviation 3.102687
Kurtosis 0.110961 Kurtosis -0.88317 Kurtosis -0.56607
Skewness -0.67729 Skewness 0.100533 Skewness 0.46645
Range
8
Range
6
Range
10
Minimum
10
Minimum
7
Minimum
6
Maximum
18
Maximum
13
Maximum
16
Sodium/Salt
Control
Questionnaire
Mean
Standard
Deviation
Kurtosis
Skewness
Range
Minimum
Maximum
7.2
2.27303
0.000987
0.865383
8
5
13
It is evident from table - 2 that mean and standard deviation scores of non-obese female
students of BHU in relation to prudent diet questionnaire, Calorie Control Questionnaire,
Fat/Cholesterol Control Questionnaire, and Sodium/Salt Control Questionnaire have been
found 14.9, 10.24, 9.72, & 7.2 and 1.9, 1.8, 3.1 & 2.2 respectively whereas range of scores
was found 8, 6, 10, & 8 respectively.
Table-3
T-Ratio for the comparison of Means of Obese and Non-Obese Female Students of
Banaras Hindu University in Prudent Diet Questionnaire
Groups
T-Ratio
Obese
Mean
Variance
Mean
14.4
4.583
14.92
Non-Obese
Variance
.896*
3.827
Table-4
T-Ratio for the comparison of Means of Obese and Non-Obese Female Students of
Banaras Hindu University in Calorie Control Questionnaire
Groups
T-Ratio
Obese
Mean
Non-Obese
Variance
Mean
Variance
.608*
9.8
9.75
10.24
3.36
The graphical representation of means between obese & non-obese female students of BHU
in relation to calorie control questionnaire has been presented in figure No.2.
Table-5
T-Ratio for the comparison of Means of Obese and Non-Obese Female Students of
Banaras Hindu University in Fat/Cholesterol Control Questionnaire
Groups
T-Ratio
Obese
Mean
Variance
Mean
Non-Obese
Variance
1.785*
11.44
13.59
Level of Significance at 0.05 level
9.72
9.63
Table-6
T-Ratio for the comparison of Means of Obese and Non-Obese Female Students of
Banaras Hindu University in Sodium/Salt Control Questionnaire
Groups
T-Ratio
Obese
Mean
Variance
Mean
Non-Obese
Variance
.718*
6.8
2.58
Level of Significance at 0.05 level
7.2
5.17
Discussion of Findings
The scholar examined the nutritional differentials between obese and non-obese female
students of BHU. The results of the study in general revealed that there was insignificant
difference in following three nutritional variables i.e. prudent diet, calorie control, and
sodium/salt control between obese and non-obese female students of BHU whereas
significant difference was found between obese and non-obese female students in case of
fat/cholesterol control.
From the findings of the study, in case of prudent diet it was evident that the insignificant
difference was found between obese & non-obese female students of BHU. Further,
graphical picture represents that non obese females have high mean value in comparison
to obese females in relation to prudent diet. The findings may be attributed to the fact that
prudent diet habits referring to general nutritional balance and obese females due to their
overweight may be under the process of dieting and score lower in form of mean score in
comparison to non obese females who have scored high indicate that they have positive
nutritional balance means high intake of calories and less expenditure of calories.
In case of calorie control the findings of the study revealed that the insignificant difference
was found between obese & non-obese female students of BHU. Further, graphical
picture represents that obese females have less mean value in comparison to non obese
females in relation to calorie control, Calorie control habits pertaining to weight loss and
gain. Obese females those have already overweight may be conscious about their
overweight and under the process of dieting thats why score lower in form of mean score
in comparison to non obese females who wants to put on weight and in tendency of high
intake of calories in their diet.
obese female students of BHU. Further, graphical picture represents that obese females
have less mean value in comparison to calorie control obese females in relation to
sodium/salt control. The findings may be attributed to the fact that sodium or salt control
which affects blood pressure and obese females may be conscious about their health due
to overweight which lead to risk of cardio-vascular risks and in habit of less intake of
salt/sodium rich diet in comparison to non obese females who have in tendency of
consuming salt/sodium rich diet.
The findings of the study are in strong consonance with the findings of Greene GW &
Schembre SM (2011), Guest J, & Bilgin A, (2010), Darcy L. Johannsen, & James P.
DeLany (2008), Feifei Wang, & Tim McDonald (2005), & Jacques Rigoaf (2001).
It became apparent; however, in the present study that there were insignificant differences
in nutritional variables of obese and non obese females of BHU in relation to prudent
diet, calorie control, and sodium/salt control whereas significant difference was found in
obese and non obese females of BHU in relation to fat/cholesterol control.
Discussion of Hypothesis
The findings of the present study strongly indicate that there were insignificant differences
in selected nutritional variables of obese and non obese females of BHU. Hence, the
hypothesis earlier set that there might have been significant differences in selected
nutritional variables of obese and non obese females is rejected and accepted in case of
fat/cholesterol control variable.
26
Chapter V
SUMMARY, CONCLUSION, AND RECOMMENDATIONS
Summary
The statement of the problem was stated as Nutritional Assessment and its
Comparison between Obese and Non-Obese Female Students of Banaras Hindu
University.
The objectives of the study were: To assess the nutritional status of obese and nonobese female students of Banaras Hindu University.To compare the obese and nonobese female students of BHU in relation to nutritional Status.
It was hypothesized that there might have been significant differences in nutritional
status between obese and non-obese female students of Banaras Hindu University.
For the purpose of the study, fifty female students of BHU (25 obese & 25 non-obese)
had been randomly selected as the subjects for the study. The age level of the subjects
was ranging from 18 to 28 years.
Keeping the feasibility aspect in mind the following variables were selected for present
study:
a.
b.
c.
d.
27
1.
Prudent Diet was assessed by the total scores in Prudent Diet Questionnaire.
2.
3.
4.
Conclusions
On the basis of the findings of the study, the following conclusions are drawn:
1.
28
2.
Non obese females have high mean value in comparison to obese females in
relation to prudent diet.
3.
4.
Non obese females have high mean value in comparison to obese females in
relation to calorie control.
5.
Significant difference was found between obese & non-obese female students
of BHU in relation to fat/cholesterol control.
6.
Obese females have high mean value in comparison to non obese females in
relation to fat/cholesterol control.
7.
8.
Non obese females have high mean value in comparison to obese females in
relation to sodium/salt control.
Recommendations
In the light of the conclusions drawn; the following recommendations are made:
1.
2.
3.
Education teachers and mentors should take into consideration the nutritional
pre requisites of females in enhancing wellbeing.
4.
5.
6.
29
7. The similar study can be conducted on other regions of India with other age groups.
30
Appendix - A
Raw Scores of Nutritional Assessment of Obese Females
Nutritional Assessment
obese Females
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
PDQ
17
16
11
11
12
12
18
18
15
14
15
13
12
14
15
11
16
14
16
16
15
16
16
15
12
CCQ F/CCQ
87
810
78
77
67
712
811
1410
1313
1017
714
610
79
96
1314
77
1313
97
1012
1212
1517
1517
1517
1217
712
S/SCQ
9
6
6
5
7
7
9
8
7
7
5
6
6
6
12
7
7
9
5
5
6
6
6
6
7
31
Appendix - B
Raw Scores of Nutritional Assessment of Non Obese Females
Nutritional Assessment
Non - obese Females
PDQ
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
13
17
16
12
13
12
17
14
16
14
13
16
15
16
17
10
17
15
18
14
15
16
15
17
15
CCQ
12
9
12
11
10
7
9
12
10
9
13
8
9
13
10
7
10
13
10
9
10
12
13
9
9
F/CCQ
S/SCQ
9
12
6
7
12
6
9
10
10
6
10
6
9
6
12
6
12
11
14
7
13
16
16
9
8
6
9
7
5
6
5
11
7
6
13
6
10
8
9
5
9
6
5
5
5
5
9
5
10
32
BIBLIOGRAPHY
Books
Gibson, R. S. (2005). Principles of Nutritional Assessment, Second Edition, Oxford University
Press, Oxford.
Journals and Periodicals
Greene, G. W., Schembre, S. M., White, A. A., Hoerr, S.L., Lohse, B., Shoff, S., Horacek, T.,
Riebe, D., Patterson, J., Phillips, B.W., Kattelmann, K.K., Blissmer, B. (2011) Identifying
clusters of college students at elevated health risk based on eating and exercise behaviors and
psychosocial determinants of body weight.
Department of Nutrition and Food Sciences, University of Rhode Island, 10 Ranger Rd, 112
Ranger Hall, Kingston, RI 02881, USA. gwg@uri.edu HYPERLINK "javascript:AL_get(this,
'jour', 'J Am Diet Assoc.');" J Am Diet Assoc. 3:394-400.
Guest, J., Bilgin, A., Pearce, R., Baines, S., Zeuschner, C., Rossignol-Grant, C.L., Morris,
M.J., Grant, R. (2010) Evidence for under-nutrition in adolescent females using routine dieting
practices. Australasian Research Institute, Sydney Adventist Hospital, Wahroonga, NSW, 2076
Australia. rossg@sah.org.au Asia Pac J Clin Nutr.4: 526-33.
Feifei Wang, Tim McDonald, Bonnie Reffitt, and Dee W. Edington, (2005) BMI, Physical
Activity, and Health Care Utilization/Costs among Medicare Retirees.
Obes Res.13:1450-1457.
Unpublished Literature
Miscellaneous
Edington, J. (1999). Problems of nutritional assessment in the community. Proc Nutr Soc; 58: 4751.
www.biologyonline.com