Suraiya Ismail and Mary Manandhar, (eds), (1999), Better Nutrition for Older People--Assessment and Action.

Salih, Osama A.

Suraiya Ismail and Mary Manandhar, (eds), (1999), Better Nutrition for Older People--Assessment and Action. HelpAge International, 67-74 Saffron Hill, London EC1N 8QX, UK. p79, ISBN: 1 872590 40 3

HelpAge International and the London School of Hygiene and Tropical Medicine have collaborated to produce a new self-instructive guide and manual, Better Nutrition for Older People Assessment and Action. Older persons were measured in India, Tanzania and Malawi to provide the basic experience and information. The handbook, concerned only with elderly under nutrition.

The handbook consisted of 79-pages divided into six chapters: 1. Background to Nutritional Assessment; Anthropometric Measurements; Assessing Nutritional Status from Anthropometric Measurements; Assessing Nutritional Vulnerability; Interventions--A Brief Overview; and Conclusion. A bibliography is included, in addition to ten appendices (including a Glossary of Terms). There are four diagrams and nine numbered tables distributed throughout the text. The handbook targeted mainly the community health workers in developing Countries.

The second and third chapters constitute a handbook for diagnostic "assessment" of nutritional status as defined by reference standards of body composition. The measurements are height, weight, armspan (or its proxy measurement of the "halfspan") and mid-upper-arm circumference (MUAC).

The Appendix 5 consists of three "BMI Charts": multicolored, nomogram-based graphs in which a subject's BMI value can be easily determined; moreover, the nutritional classification is included in the color coding. The criteria used in Appendix 5: Chart 1 are those of James and Ralph (1992) in which severe undernutrition of <16 kg/[m.sup.2] is the red area of the upper right diagonal field, 16 to 16.9 kg/[m.sup.2] is the yellow area of moderate under nutrition, and 17 to 18.5 kg/[m.sup.2] is mild undernutrition, signified by a blue band.

A broader green area encompassing 18.5 to 24.9 kg/[m.sup.2] represents adequate nutrition, and in the extreme lower left field shaded in purple includes those who are overweight at >25 kg/[m.sup.2]. In keeping to its focus on undernutrition, this manual did not include an area for obesity, defined as BMI >30 kg/[m.sup.2], nor for extreme or morbid obesity, defined as >40 kg/[m.sup.2].

The chapter; "Interventions--A Brief Overview." addresses the issue of "how you can promote better nutrition amongst the older people that you work with."

By: Osama A. Salih, Associate Professor, Nutrition Center for Training and Research, Ahfad University for Women