Stages of Nutritional Injury

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Healthy or
Possible Risk of
Nutritional Injury
(Genetics:Genotype
Host:Phenotype
Environment: Agents)
Stage I
Diminishing Reserves/
Building Excess
Stage II
Reserves
Exhausted
Stage III
Physiologic and Metabolic Alterations
Stage IV
Nonspecific Signs and Symptoms
Stage V
Illness
Stage VI
Permanent Damage
Stage 0
Examples of Conditions

Family history of diabetes, alcoholism, celiac disease, bipolar disease
Stages 1 and 2
Omits food groups due to allergies and/or preferences

Eats 1 meal/day

Use mega-dose supplements
Fad diet use
Stage 3
Wt gain/loss in past 3-6 months

High Chol, Glu, Hcy

Relevant score on ED assessment
Stage 4
Fatigue
Headaches
Irritability
Trouble concentrating
Oral lesions
Nausea
Diarrhea
Poor appetite
Stage 5
Metabolic Syndrome

Bulimia

Gestational diabetes

Alcohol dependence

Medication with Nutrient-Drug interaction
Stage 6
Bariatric surgery

Dementia

Phenylketonuria

Xerosis with ulceration

Vit-A blindness

Pernicious anemia
Examples of Nutrients: Regular alcohol intake, Protein, Carbohydrate, Vit A, D, Fol, E, C, Iron, CA Low Fol, Vit B12, C, Iron, Ess. Fatty Acids, Hi Trig,Chol, Hcy B-Vit deficiency
Low carb intake Insufficient or excess Calorie intake
Low Vit, Min intake MAOI Medication Lactose intolerance Vit B12, A, Phenylalanine

Adapted with permission from Guillermo Arroyave. Arroyave G. Genetic and Biologic Variability in Human Nutrient Requirements. Young R & Scrimshaw NS. American Journal of Clinical Nutrition, 1979; 32:486-500.