Describe the clinical and biochemical methods of nutritional assessment. Add a note on their merits and demerits.

1. 1 · Open in two lines. Clinical examination looks for visible signs of malnutrition; biochemical tests measure nutrients or their markers in blood and urine. Together they confirm what anthropometry and diet surveys suggest.
2. 2 · The clinical method. Head-to-toe examination in daylight using a schedule; the WHO grouping of signs into three groups.
3. 3 · Draw the head-to-toe table. [Table: body part, sign, deficiency: hair, eyes, lips, tongue, gums, neck, skin, nails, bones, oedema]
4. 4 · The biochemical method.
   • Hb and ferritin (iron); albumin (protein).
   • Serum retinol (vitamin A); urinary iodine.
   • Vitamin D, folate and B12; riboflavin enzyme test.
5. 5 · Biophysical and functional tests. Dark adaptation, X-ray for rickets, grip strength, work capacity.
6. 6 · Merits and demerits.
   • Clinical: quick and cheap, but late and non-specific.
   • Biochemical: early and objective, but costly and needs a laboratory.
7. 7 · In the community. Point-of-care Hb tests and clinical screening at PHCs link cases to Anemia Mukt Bharat and vitamin A rounds.
8. 8 · Close in one line. Clinical signs show the tip of the iceberg; biochemical tests show what lies below.

Scoring tip: The head-to-toe table earns most of the marks; learn it in body order so you never miss a row.