Glossary of terms
Diet
A dietary regimen (nutritional plan) for an individual, which must meet specific requirements, for medical reasons.
Dietary prescription
The program of requirements upon which the diet is based.
Dietary advice
The dietary prescription expressed in terms of foods.
Dietary recommendations
The national Nutritional Guidelines expressed in terms of foods.
Nutritional Guidelines
The Guidelines for a Healthy Diet are intended to support the government in developing nutritional policy and monitoring the effects of such policy. The recommendations also form the foundation of our national nutrition information campaigns. The previous recommendations were formulated in 1986. The guidelines in the current recommendations were tested in current scientific research.
Recommended allowance
This is the level sufficient for virtually the entire population, derived from the average requirement. It is described in various reports on nutritional standards issued by the Health Council.
Good growth curve
Growth according to a certain percentage line, which is correct for that child, taking into account normal variations in growth.
Standard deviation score (SDS, or Z-score)
Calculates the degree of standard deviation above or below the mean, from various reference tables (such as “weight-for-height”)
child’s measured value – mean value
SDS (Z -score) = _______________________________________
standard deviation
Good nutritional status
Having a sufficient amount of all the nutrients required by the body at a given time.
Body Mass Index (BMI)
The BMI indicates whether someone’s weight is in balance with their height. The weight is divided by the square of the height:
weight (kg)
Body Mass Index (BMI) = ___________
height² (m²)
Energy Requirements
Adults
Basal metabolic rate (calculated using the Harris Benedict equation1) plus extra allowances for factors such as specific-dynamic action, activities, stress and weight gain. If the extra allowances differ for certain health conditions, that will be indicated in the protocol for that particular disease.
For more information, see: Weijs PJM, Kruizinga HM et al. Validation of predictive equations for resting energy expenditure in adult outpatients and inpatients. Clin Nutr (2007), doi:10.1016/j.clnu.2007.09.001.
Children
Resting Metabolic Rate (calculated using the Schofield equations) plus amounts added for disease, activities, normal growth, catch-up growth and energy loss in movement of the bowels. For more information, see: Taminiau JAJM, Meer K de, et al, editors. Werkboek enterale voeding bij kinderen. Amsterdam: VU Boekhandel/Uitgeverij BV.; 1997. See also: www.stuurgroepondervoeding.nl > ziekenhuis > toolkit kinderen.
Validated screening tools for malnutrition
Screening in the hospital setting
Both the SNAQ (Short Nutritional Assessment Questionnaire) and the MUST (Malnutrition Universal Screening Tool) can be used for this. The SNAQ is a “quick-and-easy” screening tool; one can diagnose whether malnutrition is present by asking three questions. For the MUST, the BMI (Body Mass Index) and the percentage of weight loss must be calculated for each patient, and the patient is assigned a disease factor.
Screening in the outpatient setting
For outpatient clinics, a combination of SNAQ and BMI is recommended.
Screening children
Children are screened by taking their weight and height measurements. The measurements should be entered into the correct growth curves (based on sex and ethnicity), and the SD scores should be calculated. In addition, the STRONGkids tool can be used to screen for the risk of malnutrition during a hospital stay.
Screening in nursing home and assisted living settings
The SNAQRC (Short Nutritional Assessment Questionnaire for Residential Care) is available for malnutrition screening in nursing homes, assisted living facilities and long-term care facilities. This screening tool works with a “stoplight” score; by asking three questions and measuring the BMI, one can determine whether a patient is acutely malnourished (red) or moderately malnourished (orange).
Screening in primary care and home care settings
In primary care and home care, malnutrition can be identified in the elderly (> age 65) using the SNAQ65+ (Short Nutritional Assessment Questionnaire for 65+) and in adults (ages 18-65) by calculating the BMI and the percentage of unintended weight loss.
For more information on validated screening tools, go to: www.stuurgroepondervoeding.nl.
Conversion factors
1000 mg calcium = 25 mmol calcium
1000 mg sodium = 43 mmol sodium
1000 mg NaCl (table salt) contains 400 mg sodium
1000 mg potassium = 26 mmol potassium
1000 mg of urea = 17 mmol of urea
1 kcal (kilocalorie) of energy = 4.2 kJ (kiloJoules) of energy
1 Roza AM, Shizgal HM. The Harris Benedict equation reevaluated: resting energy requirements and the body cell mass. The American Journal of Clinical Nutrition 40: JULY 1984, pp 168-182.
