What Is a Nutritional Assessment?

A considerable percentage of senior citizens in the United States do not maintain healthy eating habits. This can occur for a variety of reasons (which will be discussed later). In order to ascertain if an older individual has an issue with obtaining appropriate nutrition on a consistent basis, the need may arise to undertake a more formal assessment of that individual’s diet. One such formal step is to undertake a nutritional assessment.

World Health Organization Definition of Malnutrition 

Technically speaking, a nutritional assessment is designed to identify malnutrition. If you are like most people, when you read or hear the word malnutrition, you (understandably) think of an individual who does not have or get enough to eat. 

In fact, inadequate nutrition is only one type of malnutrition (or improper nourishment). According to the World Health Organization, malnutrition includes:

  • Inadequate nutritional intake (as was just noted)
  • Excessive nutritional intake 
  • Imbalanced nutritional intake

In layperson’s terms, malnutrition can mean:

  • Eating too little
  • Eating too much
  • Eating the wrong stuff

Components of a Nutritional Assessment

According to the National Institutes of Health, a true nutritional assessment is a multifaceted endeavor. The basic components of a nutritional assessment are:

  • Anthropomorphic
  • Biochemistry
  • Clinical
  • Nutritional deficiencies
  • Dietary


An anthropomorphic examination is the first element of a nutritional assessment. An anthropomorphic assessment consists of the measurement of the size, weight, and proportions of a human body.​​​

The first step in an anthropomorphic element of a nutritional assessment is to ascertain an individual’s weight. Weight is strongly connected to a person’s health status. Losing weight unintentionally can be an indicator of poor health. Weight gain can be indicative of poor nutritional practices. It might also be a side effect of a medication a person is taking.

The second step in an anthropomorphic element of a nutritional assessment is to ascertain an individual’s height. The third step is to make a weight to height determination. This determination is a useful calculation when it comes to determining the overall health of a particular individual.

Finally, the anthropomorphic element of a nutritional assessment calls for what is known as mid upper arm circumference measurement. This is a tool that aids in determining the nutrient reserves in muscle and fat.


The second element of a nutritional assessment is biochemistry. The biochemical element of a nutritional assessment looks at the levels of nutrients in a person’s body. This specifically is accomplished by looking at the levels of nutrients and chemicals in a person’s:

  • Blood
  • Urine
  • Stool

According to the American Medical Association, this testing is sent to a lab. The results provided by a lab can be used by healthcare professionals to find information about the individual’s health, any medical problems they have, or any medical problems they might be at risk of having at a future juncture in time. Tests also measure the function of vital organs such as kidneys and liver.

Prime examples of biochemical measurements obtained as part of a nutritional assessment include:

  • Hemoglobin
  • Albumin
  • C-reactive protein
  • White cell count
  • Glycated hemoglobin
  • Sodium
  • Urea
  • Calcium
  • Phosphate
  • Magnesium
  • Micronutrients


According to John Hopkins University Medical Center, the clinical element of a nutritional assessment “looks at any health problems or diseases a person has that might impact their nutritional state or put them at risk of malnutrition. Diseases may cause an increased need for energy, a reduced energy intake, or nutritional losses.”

The clinical screening includes a consideration of such medical issues as:

  • Cancer
  • Chronic obstructive pulmonary disease
  • Heart failure
  • Gastrointestinal disorders
  • Neurological conditions
  • Surgery
  • Trauma
  • Burns
  • Mental health conditions

Nutritional Deficiencies

A nutritional assessment considers whether there is any apparent evidence of nutritional deficiencies. These include considerations of:

  • Bilateral pitting edema (swelling in feet or legs caused by fluid buildup)
  • Emaciation
  • Hair loss
  • Changes in hair color


The final component of a nutritional assessment involves dietary considerations. According to John Hopkins University School of Medicine:

An essential part of understanding nutritional health is knowing what food and fluids one is ingesting daily. A dietary assessment will provide information on how much food an individual eats, the quality of their food, any changes in appetite they have experienced, food allergies or intolerances, and times where they didn’t eat enough during or after an illness

The dietary component is comprised of five components, each of which is discussed in turn.

  • 24-hour recall: As the moniker indicates, a person is called upon to recall all of the food and drink consumed in the prior 24-hour time period.
  • Food frequency questionnaire: A food frequency questionnaire asks patients about the quality of their food, how frequently they eat, and the size of their portions.
  • Food group questionnaire: A food group questionnaire is different than the first two methods in that a healthcare professional will show the patient visuals of different types of food and food groups and ask them to identify if they ate any of that the day before. 
  • Food security assessment: Food security is defined as having physical and economic access to enough food to meet the dietary requirements for a healthy life.
  • Environmental: John Hopkins University School of Medicine explains how an environmental assessment is undertaken as part of an overall nutritional assessment. “An environmental assessment looks at an individual’s ability to shop, cook, and feed themselves. It looks at budget, mobility, meal times, and family support, particularly if nutrition is a concern.​​​It will also look at appetite, dexterity, how cutlery is used, and the general practices surrounding food.”

Once all of this data is amassed, a comprehensive nutritional assessment can be made of a particular individual. Through this assessment, recommendations can be made regarding how an individual’s overall diet can be improved with overall health and wellness as the ultimate objective.