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. 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 Diet Hx

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. 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 Reminder Foods

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 • Don’t 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??