Assignment Paper

Background: Irrespective of your career aims, we can assume that each of you will aim to contribute to efforts targeting achievement of optimal nutritional status: promoting health, preventing and perhaps even treating (if you have a clinical qualification) diseases in groups of individuals. Dietary intakes directly – but variably – impact nutritional status in all: affecting immune response and response to medical therapies for example. Nutritional status assessments are used to identify people at risk of malnutrition to enable early intervention/ referral before they become malnourished or performance outcomes or morbidity/ mortality rates for example are impacted. Whether or not you will be capturing data needed to assess nutritional status (e.g., skinfold measurements, blood chemistry or dietary intake interviews), on completion of your degree, you should all feel confident that you are able to demonstrate proficiency evaluating the potential of these methods to inform your work i.e., interpreting results (e.g., to show utility of interventions).

Task: You are required to complete a professional skills portfolio, designed using the ABCDE framework used to structure sessions included in the module. A series of components are required:

1. Introduction to you (maximum 1 side A4)

As a new (almost!) graduate, you should be able to evidence competence (not expertise) in a variety of nutritional assessment skills. You will have developed this during your course (not just this module) as well as potentially in employment/ your undergraduate degree. Write a concise introduction to yourself (reflective of information you might include on a personal profile on your CV/ job application) highlighting this competence and showing your awareness of how and why it improves your employability.

2. Nutritional Assessment Expertise

Four key areas (Anthropometry, Biochemistry, Clinical, Dietary) were covered in this module. Each is defined in the table 1, where a recommended reference (to initiate your reading) and some example methods are listed (more information is provided on Blackboard). Various techniques (some of which we introduced/ covered in class, many of which we did not) are available under each umbrella term. Not all will be relevant for every situation or population subgroup, nor will they have equal validity for use in all scenarios. Aiming to demonstrate your competence in module learning outcomes 1, 2, 4 and 5 (see proforma on Blackboard Ultra) and ability to make the appropriate choice of nutritional assessment techniques (reflecting how this might alter within low, middle, and high-income contexts and with interpretation of results for example), for each skill area (A, B, C and D) include:
a) An evidence-informed overview of how competence in this area will benefit you professionally (~ 400 words);
b) A personal competence evaluation for your theoretical knowledge, data collection and data interpretation expertise using a linear scale of 1 (no experience) to 10 (expert);
c) Details of your plans/ consideration with regard continued professional development required (or planned) to enhance your skill in each area. In total (A, B, C and D), this section should be no more than 500 words.
d) Include a tabulated log of experiences gained in data collection, analysis and interpretation of nutrition assessment methodologies used in collection of data (within your academic/ professional experience). You may choose to include your competence evaluation within this summary.

Table 1: Definition of ABCD nutritional assessment skill areas with suggested reading and example methods
Anthropometric Biochemical Clinical Dietary
Definition The scientific study of the measurements and proportions of the human body. Relating to the chemical processes and substances which occur within living organisms. Observation and treatment of actual patients rather than theoretical or laboratory studies. Relating to or provided by diet.
Suggested reading Norton K.I. (2018) Chapter 4: Standards for Anthropometry Assessment. IN: Kinanthropometry and Exercise Physiology (pp. 68-137) DOI: 10.4324/9781315385662-4
Gibson R.S. (1993). Nutritional Assessment: A Laboratory Manual. Oxford: Oxford University Press. Maqbool et al., (2008) Chapter 2: Clinical Assessment of Nutritional Status. IN: Duggan C. et al., Nutrition in Paediatrics (4th edition). Hamilton, Ontario, Canada: BC Decker Inc; 2008. DAPA Toolkit (NIHR: Cambridge Biomedical Research Centre. DAPA Measurement Toolkit website. [online]. [Date accessed]. Available from: https://dapa-toolkit.mrc.ac.uk/)

Method examples Skinfolds (subscapular, bicep, tricep, suprailiac) using Harpenden caliper. Blood tests (HbA1c, iron, CRP, albumin levels). Skin (e.g., generalised dermatitis could indicate deficiencies in Zinc, essential fatty acids). Prospective: 3 and 7-day diet diaries (weighed and estimated).
Circumference (waist, hip, mid-upper arm circumference: MUAC) Urine tests (diagnostic e.g., pregnancy, and function e.g., kidney tests) Muscles (e.g., decreased mass could indicate deficiency in protein and/or calories; tenderness in calves could indicate thiamin deficiency). Retrospective: 24 hour recall, Food frequency questionnaire; diet history.

Guidance:
• A theoretical introduction is included within the module timetable for each of these skill areas. Use this to inspire/ guide your initial research into the relevance of that area to your career development, project plans etc.
• Reflect following practical session covered in the module and elsewhere in your course on difficulties experienced collecting/ using the data you need and how you could overcome these issues (i.e., be reflective following each weekly session and following completion of the asynchronous recorded introductions provided, after reading directed materials etc.).
• Consider utility of skills used alone (compared to in combination) and the impact of these decisions on subject experience, costing, environmental constraints etc.
• Ask questions! Project supervisor, personal tutor, the module leader and/or session leads!