Clinical nutritional surveys Relationship between observed signs

Abstract

The findings of clinical nutrition surveys of 3351 children aged 8–15 years and of 3326 adults, of both sexes, were analysed statistically to ascertain the relationship existing between nutritional grade (good, fair and poor) and the incidence of a variety of clinical signs (pityriasis, folliculosis, gingivitis, etc.) observed at the time of the medical examination but not taken into account in grading the subjects according to their state of nutrition.The analysis showed negligible correlations between the clinical signs singly and collectively and the clinician's nutritional grade. Further, when we compared the incidence of each clinical sign and the nutritional state as a combination of all the clinical signs (i.e. the general nutritional factor), there was negligible agreement as shown by the low general factor saturation coefficients, thus suggesting that the presence of these signs is not a dependable expression of the general state of nutrition.A special clinical survey of 1067 children was carried out to provide data which would throw light on the relationship between the criteria (posture, muscular development, etc.) which the clinician consciously takes into account but does not as a rule record in deciding the nutritional grade, and the nutritional grade itself. The grading criteria in the survey were separately assessed and recorded and so also were the usual clinical signs (pityriasis, gingivitis, etc.).For the grading criteria there was a high degree of correlation between each one and the nutritional grade and also between each one and the combined pool of all the criteria. The clinical signs showed only negligible correlations with each other, with the nutritional grade or with any of the grading criteria.It would seem, therefore, that nutritional assessment as at present understood is determined mainly by the value placed on the grading criteria (posture, muscular development, etc.), and to a negligible extent or not at all by the presence or absence of clinical signs (pityriasis, folliculosis, gingivitis, etc.).