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

Dietary Assessment Methods

• Diet/nutrition hx

• Food frequency questionnaire

• Food record or food diary

• 24-hour food recall

Diet Hx

• Includes social hx

• From pt or sig other

• Usual food intake

• Need to do other food intake methods also

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

Estimating Nutrient Intake

• FFQ

• Food record

• 24-hour food recall

• Weighed food record

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

FFQ

• Food items

• Over a time period

• Quality of diet

• Need portion sizes to estimate nutrient intake

• Block 100-item example

Food Record

• Pt records what eaten

• Usually need 4 days

24-hour Food Recall

• Lists what has eaten in past 24 hours

Multiple Pass Method

• 1st pass - list what ate

• 2nd pass - ask for more detail

• 3rd pass - go over list of reminder

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

4 Kinds of Info in Detail

• Do this on the second pass

• Specific food

• Preparation method

• Portion size

• How food served when eaten

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

Open-ended Questions

• How

• What

• Describe

• Don’t use specific meal terms

• Invite free expression

• Cannot be answered yes or no

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

• Practice identifying open-ended questions

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

• Case study 3 questions

END

• Questions??