Community Nutrition

COMMUNITY NUTRITION 3 (1+2)

Lesson 5 : Biochemical Assessment of Nutritional Status

Assessment of protein status

1. Blood: The important proteins which are much altered are albumin and globulin. The normal albumin levels are 3.5-5.5g/dl. During Protein Energy Malnutrition (PEM) the levels may slowdown to 2.0-2.5g/dl. Also the albumin globulin ratio shows a tendency to decrease.


2. Urine: The end products of protein metabolism are urea, uric acid, creatine, hydroxyl proline etc. Reduced protein intake is reflected in decreased protein turnover which in turn affects the levels of proteins in blood and the levels of protein end products in urine. The indices calculated based on these above said protein metabolites indicate the protein status.
   
   
   
   In normal children, the index is 4.7, the index decline in kwashiorkor and marasmus.
   
   
   
   It should be more than 12
   
   The measurement provides an approximate idea of the musculature of the child and it is of value in assessing the recovery of malnourished children as well as the detection of marginal nutrition.
   
   Fasting urinary urea nitrogen and creatinine nitrogen ratio
   
   
   
   It should be more than 12
   
   Children eating diets low in protein show low ratios of urinary urea to creatinine.


3. Serum Amino acid ratio (AAR): This ratio of non-essential/essential amino acids is very sensitive at an early stage of PEM as also for kwashiorkor. This test is not sensitive to marasmus.