Diet history
Diet history, provides detailed information from which to formulate a nutrition plan that work best for the client. Dietary plans, just like exercise routines, need to be individualized for best results. Keeping a detailed dietary diet history allows you to find the foods and food combinations that work best for the client at the correct times of day. Methods that are used to provide this nutritional information are getting your client to fill out a 24 hour recall – great for finding out a quick list of foods ate, how much and when they were consumed. This is only a quick way of finding out a person’s diet and doesn’t delve into great detail. A 3-Day Food Diary is a very useful tool to analyse dietary intake. As well as an accurately recorded diary of your food intake, this then allows us to give recommendations according to diet and fitness goals based on the results.
Anthropometric measurements
Anthropometric measurements are techniques for determining an individual's body fat composition by measuring, recording, and analysing specific dimensions of the body, such as height and weight; skin-fold thickness; and bodily circumference at the waist, hip, and chest. They are also a great tool for recording and measuring growth against previous tests. These tests are to be used mainly as a guide, as there is no differentiation of muscle and body fat, so a bodybuilder for example can be mistaken as obese due to their size which is completely inaccurate. Also body fat distribution is not taken into account during these tests.
Height/Weight
The height weight chart is a guideline to your ideal bodyweight. Because muscle tissue weighs more than fat per volume, this kind of test / chart will give very inaccurate figures for leaner people, which means most athletes would be looked upon as being obese
BMI
BMI stands for Body Mass Index. It is a measure of body composition. BMI is calculated by taking a person's weight and dividing by their height squared - (W/H2) = BMI. The higher the figure the more overweight you are. Like any of these types of measures it is only an indication and other issues such as body type and shape have a bearing as well. BMI is just a guide - it does not accurately apply to elderly populations, pregnant women or very muscular athletes such as weightlifters.
http://www.topendsports.com/testing/tests/BMI.htm
Waist to hip ratio
The purpose of the waist to hip ratio test is to determine the ratio of waist circumference to the hip circumference and divide them by each other. Waist to hip ratio has been shown to be related to the risk of heart disease, high blood pressure and diabetes. The formula for calculation waist to hip ratio is (waist girth / hip girth) = WHR. To find out someone's waist-to-hip ratio, measure the waist at its narrowest point, and then measure the hips at the widest point.
- Waist circumference is measured midway between the lower rib margin and the iliac crest in the horizontal plane.
- While the subject is standing, hip circumference is measured at the point with the maximum circumference over the buttocks using a tape measure to measure to the nearest 1cm.
http://www.topendsports.com/testing/tests/WHR.htm
Skin fold measurements
Taking skin fold measurements is a common method for determining body fat composition. Measurement can use from 3 to 9 different standard anatomical sites around the body. The tester pinches the skin at the appropriate site to raise a double layer of skin and the underlying tissue, but not the muscle. The callipers are then applied 1 cm below and at right angles to the pinch, and a reading in millimetres (mm) taken two seconds later. The mean of two measurements should be taken. If the two measurements differ greatly, a third should then be done, then the median value taken. Below is a table of general guidelines (based on personal experience) for using total sum (in millimetres) of the seven main skin fold sites (tricep, , , , supra-illiac, , , ). Measurements are taken on the right side only (for consistency), the measurements can be compared to reference data and person’s previous measurements, also these measurements are suitable for all people though may not be reliable for obese people.
http://www.topendsports.com/testing/tests/skinfolds.htm
Basic Fitness Tests
Basic fitness tests such as resting heart rate, blood pressure, handgrip dynamometer and bio-electrical impedance are undertaken to develop an understanding of the individual’s health status and to have previous data to compare to as the individual increases their fitness levels.
RHR
Your heart rate can be taken at any spot on the body at which an artery is close to the surface and a pulse can be felt.
Carotid Pulse (neck) - To take your heart rate at the neck, place your first two fingers on either side of the neck. Be careful not too press to hard, then count the number of beats for a minute.
Radial Pulse (wrist) - place your index and middle fingers together on the opposite wrist, about 1/2 inch on the inside of the joint, in line with the index finger. Once you find a pulse, count the number of beats you feel within a one minute period.
You can estimate the per minute rate by counting over 10 seconds and multiplying this figure by 6, or count over 15 seconds and multiply by 4, or over 30 seconds and doubling the result. There are obvious potential errors by using this shorthand method. If you have a heart rate monitor, this will usually give you an accurate reading. Your resting heart rate is best taken first thing in the morning before you get up or intake things such as caffeine as this will cause it to rise, other things that cause your heart rate to rise are illness- If you have fever, you’re heart rate accelerates with 10-15 beats for every degree your temperature goes up. Dehydration- If you’re dehydrated your total blood volume goes down and forces your heart to beat faster. Overtraining and lack of recovery from previous training sessions - If you’ve performed a hard training session the days before, it’s very likely that your resting heart rate is 4-to 8 beats higher than normal. This is a response to intensive training. It doesn’t always mean you have overtrained but can be an indication to rest longer before training again.
Blood Pressure
An individual’s blood pressure is taken as it’s an important measurement related to the risk of heart disease. This test is always taken first as other tests can affect the outcome. BP is recorded in units of millimetres of mercury, a reading of around 120/80mm Hg is considered to be a normal blood pressure reading; where as readings of 141/50 mm Hg to 160/95 mm Hg put you in a moderate to high risk category, a reading higher than 160/95 mm Hg puts you in the highest risk category. After 4 consistent high blood readings it is recommended to see your GP as soon as possible as the high readings make you more likely to have a heart attack or stroke.
http://www.topendsports.com/testing/tests/blood-pressure.htm
Handgrip Dynamometer
Handgrip dynamometer test is used to measure the maximum isometric strength of the hand and forearm muscles. Handgrip strength is important for any sport in which the hands are used for catching, throwing or lifting. Also, as a general rule people with strong hands tend to be strong elsewhere, so this test is often used as a general test of strength. The best result from several trials for each hand is recorded, with at least 15 seconds recovery between each effort. The values listed below (in kilograms) give a guide to expected scores for adults.
Bioelectrical Impedance
Bioelectrical impedance measures the resistance of body tissues to the flow of a small, harmless electrical signal. The proportion of body fat can be calculated as the current flows more easily through the parts of the body that are composed mostly of water. It is possible to predict how much body fat a person has by combining the bioelectric impendence measure with other factors such as height, weight, gender, fitness level and age. Bioelectrical impedance measurements can be affected by things such as body temperature – after exercise or bathing, how hydrated you are, the time of day its taken (if you have just woken up) and if you have eaten before the test.
Physical Appearance
The physical appearance of an individual can provide the initial signs that they may be suffering from some kind of malnutrition.
Malnutrition
Malnutrition is the condition that develops when the body does not get enough vital nutrients, such as vitamins and minerals which are needed to maintain healthy tissue and organ function. It also refers to all deviations from adequate nutrition such as under nutrition and over nutrition.
Both under nutrition and over nutrition have identifiable and visible symptoms.
Under Nutrition
Under nutrition is the consequence of consuming too few essential nutrients or using or excreting them more rapidly than they can be replaced. The most common attributes that are seen in under nutrition are thin hair, aching joints, swollen tongue, increased sensitivity to light, cracked lips and mouth, skin that is pale, thick, dry and bruises easily and also the person may look skinny or bloated and have a BMI under 18.5. Causes of under nutrition can be related to poverty and lack of food, loss of appetite associated with the ageing process, chronic disease, drug/alcohol dependency, eating disorders, food allergies and failure to absorb nutrients following weight loss surgery
Over Nutrition
The most common symptom that is seen in over nutrition is when an individual is overweight or obese, which is the result of eating too much, eating the wrongs things and not doing enough exercise. The risk of over nutrition is increased by being more than 20% overweight, consuming a diet high in fat and salt and taking high doses of: niacin [to lower cholesterol levels], vitamin B6 [to relieve PMS], vitamin A [to clear skin problems], iron or other trace elements [not prescribed]
Fat Distribution
Adipose tissue accumulation is referred to as body fat distribution.
Android [apple shaped] – fat is centred round the abdominal area
Gynoid [pear shaped] – fat accumulates around the hips and thighs
Blood chemistry results
A wide variety of things can be examined in a blood chemistry test, such as haemoglobin levels, cholesterol levels and glucose levels.
Haemoglobin
Haemoglobin is the coloured pigment inside red blood cells that carries oxygen round the body. A haemoglobin test determines the level of red blood cells in your body. L haemoglobin levels can cause anemia (lack of healthy red blood cells). Haemoglobin levels are measured in grammes per 100 millilitres (g/dl). The normal ranges are 13.5-17.5g/dl for men and 11.5-15.5g/dl for women.
Cholesterol
Cholesterol forms part of the outer membrane that surrounds every cell. It's used to insulate nerve fibres (and so make nerve signals travel properly) and make hormones, which carry chemical signals around the body. Without cholesterol, your body wouldn't work - it's vital to ensure the body's normal function. Too much cholesterol in the blood, increases the risk of coronary heart disease and disease of the arteries.
A cholesterol test determines the levels of cholesterol, triglycerides and other lipids in the blood, and the results can determine your risk factor for heart disease. Ideally recommended cholesterol levels are, total cholesterol levels less than 4.0 - 5.0 mmol/l.
Glucose
A glucose tolerance test determines how quickly glucose is cleared from the blood. The test is usually used to test for diabetes and insulin resistance. The test is performed immediately following a fast of between 8-16 hours when glucose levels are at their lowest and glucose levels are at their highest after eating. A fasting blood glucose measurement is performed immediately prior to the test. If this level is greater than 7.0 mmol/L, the test is usually not performed as this level signifies diabetes mellitus. The patient is then given a glucose solution to drink. Adults are given 75 grams of glucose, children are given an amount dependent on their weight: 1.75 g/kg body weight (up to 75 grams maximum). The patient is instructed to rest, then another blood glucose measurement is taken after 2 hours.
