Nutrition Assessment - Dietary

1
Nutrition Assessment - Dietary

• Counsel persons on nutr
• Translate nutrition needs into menus
• Methods of assessing nutrition status
• Collect pertinent info for assessment
• Asses nutritional status of pt

2
Dietary Assessment Methods

• Diet/nutrition hx
• Food frequency questionnaire
• Food record or food diary
• 24-hour food recall

3
Diet Hx

• Includes social hx
• From pt or sig other
• Usual food intake
• Need to do other food intake methods also

4
Diet Hx

• Previous diet
• Appetite
• Regularity of meals
• Likes/dislikes
• Intolerances
• Allergies
• Rapidity of eating

• Customs
• Food prep methods
• Chewing trouble
• Dentures
• Supplements
• Location of eating
• Religion culture

5
Estimating Nutrient Intake

• FFQ
• Food record
• 24-hour food recall
• Weighed food record

6
Number of Days

• Highly variable by nutrient
• kcal - need 27 or 35 days
• fat - need 57 or 71 days
• vit C - need 249 or 222 days

7
FFQ

• Food items
• Over a time period
• Quality of diet
• Need portion sizes to estimate nutrient intake
• Block 100-item example

8
Food Record

• Pt records what eaten
• Usually need 4 days

9
24-hour Food Recall

• Lists what has eaten in past 24 hours

10
Multiple Pass Method

• 1st pass - list what ate
• 2nd pass - ask for more detail
• 3rd pass - go over list of reminder

11
Reminder Foods

• Crackers, breads, rolls, tortillas
• Hot or cold cereals
• Cheese added as topping on veg or sandwich
• Chips, candy, nuts, seeds

• Fruit eaten with meals or snack
• Coffee, tea, soft drinks, juices
• Beer, wine, cocktails, brandies, any other drinks
  made with liquor

12
4 Kinds of Info in Detail

• Do this on the second pass
• Specific food
• Preparation method
• Portion size
• How food served when eaten

13
Increasing Accuracy

• Use visual aids of food
• Use visual aids of portion sizes
• Increase trust with pt before start
• Body language
• Open-ended questions
• Probing questions

14
Open-ended Questions

• How
• What
• Describe
• Dont use specific meal terms
• Invite free expression
• Cannot be answered yes or no

15
Follow-up or Probing Questions

• What did you add to that food?
• Describe what else you eat with that?
• Pause after you ask
• Obtain additional info
• Nonjudgemental in tone of voice

16

• Practice identifying open-ended questions

17
Increase Memory

• Attach to another activity
• Eating while doing food prep or driving
• What did you eat before or after this time
• Middle of night eating
• Use time to aid memory

18

• Case study 3 questions

19
END

• Questions??