NWAKWUO CHIDINMA JESSICA
2022724054
EHS 214
HUMAN NUTRITION AND DIETETICS
MRS ARONU
BIOCHEMISTRY
Nutritional biochemistry is an essential field that evaluates the nutrient status of individuals and
populations to understand how food intake impacts health and disease. I'll explore the most
common nutritional assessments in biochemistry, focusing on laboratory tests and biomarkers
used to evaluate nutritional status.
Key Aspects of Nutritional Assessment in Biochemistry
Nutritional biochemistry focuses on the chemical composition of food and how nutrients affect
metabolism, health, and disease. Nutritional assessment integrates biochemical, clinical,
dietary, and anthropometric data. The key biochemical methods for assessing nutritional status
involve measuring levels of nutrients, metabolites, or biological markers in biological fluids like
blood, urine, or tissues.
Biochemical Methods of Nutritional Assessment
1.Blood Tests for Macronutrient Levels:
● Glucose: Blood glucose levels are used to assess carbohydrate metabolism. High
levels may indicate diabetes or insulin resistance, while low levels may point to
hypoglycemia.
● Lipids: Serum cholesterol (HDL, LDL) and triglyceride levels provide insights into lipid
metabolism and cardiovascular risk. Abnormal levels suggest dyslipidemia, which can be
influenced by diet and lifestyle.
● Proteins: Serum albumin, prealbumin, and total protein levels are common indicators of
protein status. Low levels may reflect malnutrition, inflammation, or liver disease.
2.Vitamin Status:
● Vitamin A: Serum retinol levels indicate vitamin A status, which is important for vision
and immune function. Deficiency can lead to night blindness and a weakened immune
system.
● Vitamin D: 25-hydroxyvitamin D (25-OHD) is a common marker for vitamin D status.
Deficiency is linked to bone disorders like rickets in children and osteomalacia in adults.
● Vitamin B12 and Folate: Serum vitamin B12 and folate levels are critical for evaluating
red blood cell formation and neurological function. Deficiency may lead to anemia and
neurological issues.
● Vitamin C: Plasma ascorbic acid levels reflect vitamin C status, which plays a role in
antioxidant defense and collagen synthesis.
3. Mineral Status:
● - Iron: Serum ferritin, transferrin saturation, and total iron-binding capacity (TIBC) are
common markers for iron status. Iron deficiency leads to anemia, while excess iron can
cause toxicity.
● Calcium: Serum calcium levels assess bone health and are influenced by dietary intake
and vitamin D levels. Low calcium may indicate hypocalcemia, leading to muscle cramps
and osteoporosis.
● Zinc: Plasma zinc levels help assess zinc status, which is essential for immune function
and wound healing. Deficiency may impair growth and immune response.
4. Electrolyte Balance:
● Sodium, Potassium, Chloride: These electrolytes are crucial for maintaining fluid
balance and normal cellular function. Abnormal levels can indicate dehydration, renal
dysfunction, or hormonal imbalances.
● Magnesium: Magnesium is involved in over 300 enzymatic reactions in the body. Its
deficiency can lead to muscle cramps, cardiovascular disease, and metabolic disorders.
5. Enzymatic and Metabolic Markers:
● Alkaline Phosphatase (ALP): This enzyme is used to assess bone health and liver
function. Elevated levels may indicate liver or bone disease.
● Lactate Dehydrogenase (LDH): Elevated LDH levels may be a marker of tissue
damage, which could result from malnutrition, trauma, or disease.
● Thiamine (Vitamin B1) Status: Transketolase activity in red blood cells can assess
thiamine levels. Deficiency leads to conditions like beriberi and Wernicke-Korsakoff
syndrome.
Urine Tests for Nutritional Status:
● Urine tests can measure specific metabolites and help assess nutrient deficiencies or
excesses. Some common tests include:
● Nitrogen Balance: Urinary nitrogen excretion assesses protein metabolism. Negative
nitrogen balance indicates protein deficiency, while a positive balance may suggest
adequate protein intake.
● Urinary Creatinine: Urinary creatinine reflects muscle mass and kidney function.
Elevated levels can indicate muscle breakdown or renal dysfunction.
● Iodine: Urinary iodine concentration is a marker of iodine status, important for thyroid
function. Deficiency leads to goiter and developmental issues.
● Ketones: The presence of ketones in urine indicates a reliance on fat metabolism, often
seen in fasting, ketogenic diets, or uncontrolled diabetes.
Markers of Oxidative Stress and Inflammation:
● C-Reactive Protein (CRP): CRP is a marker of inflammation, which may reflect an
underlying infection, chronic disease, or malnutrition.
● Oxidized LDL: This marker reflects oxidative stress and is associated with
cardiovascular risk.
● Glutathione: Glutathione is a key antioxidant, and its levels reflect the body’s capacity to
neutralize free radicals.
Nutritional Genomics and Biochemical Assessments:
In recent years, nutritional genomics has emerged as an approach to understanding how
individual genetic variations affect nutrient metabolism and health outcomes. Genetic tests can
reveal variations that affect how the body processes nutrients like folate (MTHFR gene), vitamin
D, or omega-3 fatty acids, leading to more personalized nutrition recommendations.
Clinical Use of Biochemical Nutritional Assessments:
Nutritional biochemistry assessments are used clinically to:
● Diagnose Deficiencies: Biochemical markers are the most direct way to diagnose
nutrient deficiencies (e.g., iron deficiency anemia).
● Monitor Disease: Patients with chronic diseases such as diabetes, cardiovascular
disease, or kidney disease may need regular biochemical monitoring of nutrient levels to
prevent complications.
● Guide Nutritional Support: In hospitalized or critically ill patients, biochemical markers
are essential for assessing nutritional status and adjusting dietary interventions.
● Evaluate Malnutrition: Nutritional assessments can detect malnutrition or specific nutrient
deficiencies that affect recovery, immune function, and overall health.
Limitations of Biochemical Nutritional Assessments:
● Non-Specificity: Some biochemical markers are influenced by multiple factors. For
example, serum albumin is affected by both protein status and inflammation.
● Invasive: Blood and tissue tests are often invasive, requiring skilled professionals to
collect samples.
● Acute vs. Chronic Status: Some markers (e.g., glucose) reflect acute nutritional status,
while others (e.g., ferritin) may represent long-term nutrient stores.
Conclusion:
Biochemical assessments are crucial in understanding a person’s nutritional status, both in
clinical and public health settings. They provide valuable information about nutrient levels,
deficiencies, metabolic function, and overall health. Understanding these biochemical markers
helps healthcare providers guide dietary recommendations, monitor disease progress, and
improve patient outcomes. However, biochemical assessments should be used in conjunction
with clinical evaluations, dietary assessments, and anthropometry to obtain a comprehensive
view of an individual’s nutritional status.
BIOCHEMICAL ASSESSMENT
Biochemical assessment is a key component of a comprehensive nutritional assessment. It
involves the analysis of various biological samples, such as blood, urine, and tissues, to
evaluate the nutritional status of an individual. Biochemical tests can detect deficiencies or
excesses of nutrients, metabolic imbalances, and organ function related to nutrition.
Here are the key aspects of biochemical assessments in nutrition:
1. Macronutrient Assessment
● Protein status: Measured by serum albumin, prealbumin, and transferrin levels. Low
levels indicate protein malnutrition.
● Lipid profile: Includes cholesterol, triglycerides, and lipoproteins (LDL, HDL). These
assess fat metabolism and risk for cardiovascular disease.
● Glucose metabolism: Assessed via fasting blood glucose, insulin, and hemoglobin A1c
(HbA1c) to detect diabetes or insulin resistance.
2. Micronutrient Assessment
● Iron status: Hemoglobin, hematocrit, ferritin, and transferrin saturation are measured to
assess iron deficiency or overload.
● Vitamin levels: For example, vitamin D (measured by 25-hydroxyvitamin D), vitamin
B12, and folate are common markers. Deficiencies can cause various health issues,
such as anemia or bone disorders.
● Electrolytes and minerals: Calcium, magnesium, potassium, sodium, and phosphorus
levels are measured to assess hydration, renal function, and bone health.
3.Enzyme Function and Biomarkers
● Liver enzymes: Alanine transaminase (ALT) and aspartate transaminase (AST) are
used to assess liver function, which can be affected by malnutrition or certain diets.
● Antioxidant status: Markers like glutathione, superoxide dismutase (SOD), and vitamins
C and E are assessed to evaluate oxidative stress and potential damage due to nutrient
imbalances.
4.Hormonal and Inflammatory Markers
● Thyroid hormones: Thyroid-stimulating hormone (TSH) and thyroxine (T4) are measured
to evaluate thyroid function, which can be influenced by iodine and selenium status.
● C-reactive protein (CRP): A marker of inflammation that can be influenced by poor
nutritional status or obesity.
Biochemical assessments are particularly valuable because they provide objective, quantifiable
data that can help diagnose nutrient deficiencies or imbalances before clinical symptoms
appear. This information can guide interventions and help monitor the effectiveness of dietary
changes.
ANTHROPOMETRIC MEASUREMENTS
Anthropometric assessment is another critical component of a nutritional assessment, focusing
on physical measurements of the body to evaluate growth, development, and the overall
nutritional status of an individual. These measurements are easy to obtain and provide
important information, especially in populations where malnutrition or obesity are concerns.
Key Anthropometric Measurements:
1.Weight:
- Regular weight monitoring is essential for assessing changes in body mass, either as weight
loss or gain.
- Weight measurements are often used in combination with height to calculate other indices
like BMI.
2. Height/Length:
- Height (for adults) or length (for infants and toddlers) is a basic measurement that, when
tracked over time, provides data on growth patterns, especially in children.
- Short stature can be a sign of stunted growth due to chronic malnutrition, while unusually
rapid growth can indicate over-nutrition or other metabolic conditions.
3. Body Mass Index (BMI):
- BMI= weight (kg) / height (m²)
- BMI is a widely used tool to categorize individuals as underweight, normal weight,
overweight, or obese. It helps identify potential health risks associated with body fat.
- Underweight: BMI < 18.5
- Normal: BMI 18.5 – 24.9
- Overweight: BMI 25 – 29.9
- Obese: BMI ≥ 30
4. Waist Circumference (WC):
- Waist circumference is a useful indicator of central (abdominal) obesity, which is associated
with a higher risk of cardiovascular disease, type 2 diabetes, and metabolic syndrome.
- High-risk values:
Men: ≥ 40 inches (102 cm)
Women: ≥ 35 inches (88 cm)
5. Waist-to-Hip Ratio (WHR):
-WHR = waist circumference / hip circumference
- A high WHR indicates central fat accumulation, a strong predictor of cardiovascular disease
and other metabolic conditions.
- Men: WHR > 0.90
- Women: WHR > 0.85
6. Skinfold Thickness:
- Skinfold measurements are used to estimate subcutaneous fat stores. Common sites include
the triceps, biceps, subscapular, and suprailiac regions.
- Calipers are used to measure the thickness of the skinfold, which can then be used to
estimate total body fat percentage.
7. Mid-Upper Arm Circumference (MUAC):
- MUAC is commonly used in assessing malnutrition in children and pregnant women. It helps
identify individuals with severe acute malnutrition.
- Low MUAC indicates muscle wasting and fat loss, especially in malnourished populations.
8. Head Circumference (in infants and children):
- Head circumference is measured to assess brain growth and development. Slower growth in
head circumference can indicate chronic malnutrition or developmental issues.
Growth and Development Charts:
- Percentiles: For children, anthropometric measurements like weight, height, and head
circumference are plotted on growth charts based on age and gender. This helps in assessing
whether the child is growing normally or if there are signs of stunting, wasting, or overweight.
- Z-scores: Z-scores (standard deviation scores) are used to compare a child's
measurements to a reference population. For example:
- Height-for-age Z-score (HAZ): Indicates stunting (chronic malnutrition).
- Weight-for-height Z-score (WHZ): Indicates wasting (acute malnutrition) or overweight.
Summary of Use:
- Malnutrition: Low BMI, low weight-for-age, low MUAC, or stunted growth (low height-for-age)
indicate malnutrition.
- Obesity/Overweight: High BMI, large waist circumference, or high WHR indicates overweight
or obesity, which are risk factors for metabolic disorders.
- Muscle Wasting: Decreased MUAC or skinfold thickness indicates loss of muscle mass, often
due to chronic illness or malnutrition.
These anthropometric assessments provide a practical and reliable way to assess nutritional
status, detect risks for diseases, and track changes over time.
