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The Importance of Context in Choosing Nutritional Indicators^1,2,

³ Division of Nutritional Sciences, Savage Hall, Cornell University, Ithaca, NY 14853 ⁴ Cornell Food and Nutrition Policy Program, Division of Nutritional Sciences, Savage Hall, Cornell University, Ithaca, NY 14853

Nutritional indicators are used to screen, diagnose, and evaluate interventions in individuals. They are also used in populations to ascertain and place under surveillance the magnitude of nutritional problems, their location and causes, and to evaluate the impact of programs and policies. Nutritional indicators are also used for research to make inferences about biological and social mechanisms affecting or being affected by nutrition. All these activities include measurements of nutritional indicators, but the choice of indicators, their measurements, analyses, and the need for other data can be very different for inferences from research, for patient management, for making public policy, or for planning or evaluating programs. There is no best indicator, best measure of an indicator, or best analysis of an indicator in a generic sense. The definition of "best" depends ultimately on what is most appropriate for the decision that must be made. This paper gives examples.

KEY WORDS: • decision making • risk factors • social justice • nutrition • data collection

¹ Presented as part of a conference, "Nutrition Monitoring and Nutrition Status Assessment", at the first fall meeting of the American Institute of Nutrition, Charleston, South Carolina, December 8–10, 1989. The conference was supported in part by cooperative agreement HPU880004-02-1 with the DHHS Office of Disease Prevention and Health Promotion, the USDA Human Nutrition Information Service, the DHHS National Center for Health Statistics, and the International Life Sciences Institute-Nutrition Foundation.

² The Planning Committee for the meeting consisted of Drs. Helen A. Guthrie, Roy J. Martin, Linda D. Meyers, James A. Olson, Catherine E. Woteki, and Richard G. Allison (ex officio). The symposium papers were edited by a committee consisting of Dr. James Allen Olson (coordinator), Dept. of Biochemistry & Biophysics, Iowa State University, Ames, IA; Dr. Cathy C. Campbell, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Roy J. Martin, Dept. of Foods & Nutrition, University of Georgia, Athens, GA; and Dr. Catherine E. Woteki, Food & Nutrition Board, National Academy of Sciences, Washington, DC.

Manuscript received 10 December 1989. Revision accepted 11 July 1990.

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