Clinical Nutrition Examination

Common nutritional disorders can be assessed by close examination of skin, nails, mouth, and eyes [3].

Skin

Dermatitis—vitamin B₆, zinc

Impaired wound healing—vitamin C, zinc, protein

Rash (arms, legs)—niacin

Bruising—vitamin K₁

Dry flaky skin—essential fatty acids, vitamin A Depigmentation—protein calorie malnutrition Pallor—iron, vitamin B₁₂, folate Nails

Spoon-shaped—iron deficiency Discolored—selenium toxicity Ridged—protein calorie malnutrition

Hair

Discoloration, dullness, loss—protein calorie malnutrition Alopecia—biotin deficiency Eyes

Poor night vision—vitamin A Oral

Swollen, bleeding gums—vitamin C Bones and Joints

Beading ribs, bowlegs—vitamin D Neurological

Disorientation—thiamine

Peripheral neuropathy—thiamine, vitamin B₆, vitamin B₁₂

Psychosocial Support

Reviewing the bariatric surgery candidate’s age, occupation, educational level, marital status, income, living arrangements, and dependents provides a more complete snapshot of how to proceed with the nutrition education needed for success postsurgery.