Nutritional assessments aim at evaluating the nutritional status of individuals, including many factors that influence or reflect nutritional health. To prepare a nutritional assessment, the assessor, usually a trained and licensed professional, uses historical information which includes diet history, anthropometric measures, physical examinations, and laboratory tests. Each of these methods involves collecting data in various ways an interpreting each finding in relation to the others to create a total picture.
An estimate of energy and nutrient intakes from a diet history, combined with other sources of information can help confirm or rule out the possibility of suspected nutritional problems. Amounts of nutrients consumed are determined either manually (Food Composition Tables) or by computer analysis, and then compared with established standards such as the Recommended Daily Dietary Allowances (RDA) and dietary guidelines, to determine if intake is adequate, excessive or deficient. To determine if the one-day intake was balanced, it is compared with the Food Guide Pyramid I terms of number of servings per food group.
We have learned that when there is a deficiency or excess of a specific nutrient this can lead to some type of malnutrition, either undernutrition or overnutrition. Undernutrition is a deficiency of energy of nutrients. Symptoms of undernutrition related to decreased energy intake can present as decreased weight, loss of muscle tissue, and prone to infection or disease. With a deficiency of a specific nutrient, symptoms such as skin rashes, depression, hair loss, and bleeding gums, muscle spasms, or other symptoms may be present. When there is a prolonged excess of energy intake, an individual may become obese and prone to chronic conditions, such as heart disease and diabetes.
Trained clinicians, such as Registered Dietitians or nutritionists, use nutrition screening tools to help diagnose patients or clients with malnutrition. This type of assessment is part of the dietary evaluation or historical information gathering. Creating an appropriate tool to assess individuals should include the multitude of factors that can influence an individual’s diet, for example:
- Family history
- Drug use: nutrient-drug interactions, symptoms of medications (i.e. loss of appetite, nausea, etc)
- Social factors: marital status, ethnic background, education levels, and economic conditions
- Physiological characteristics: age, height, weight (unintentional weight gain or weight loss), BMI, depression, mobility, existing conditions
- Cultural aspects: types of foods traditionally eaten, cook at home, or eat out
- Convenience foods
- Resources available: adequate access to full service grocery store or fresh fruits and vegetables, access to a kitchen, etc.
Envision yourself as a private practice or outpatient dietitian. In an effort to recruit patients, you are offering free introductory counseling sessions to build up your client base. The sessions include a comprehensive nutrition analysis, with screening, diet analysis, and education and recommendation on areas in need or concern.
Your assignment is to create a nutrition survey tool and a food frequency questionnaire that will you utilize with your clients.
In addition, you must complete a 24 hour recall and a 3 day food record on yourself.
Data from the 24 hour recall and the 3 day food record must be analyzed for nutritional adequacy. Compare your intake with the RDA and calculate their percent intake from each of the macronutrients. Please turn in all data forms and provide a brief written analysis regarding areas you are adequate in, areas for improvement or concern, and recommendations provided.
The screening tool must be comprehensive to obtain a full picture of one’s dietary health.
You will need to turn in a copy your survey tool and the results and BRIEF analysis of the 24 hour intake and the 3 day food record for yourself. Some information to consider when writing your analysis:
- Nutrition screening forms
- Food frequency questionnaires
- Nutrient analysis and comparison to recommendations
- Summary of nutrient adequacies and deficiencies
- What could the individuals do to improve their diet?
- How well does their diet compare with established standards?
- In addition, what type of education did you provide and the recommendations provided.
- If you would recommend a follow up session, indicate this as well.
Written analysis:Easy to understand and organized in a logical manner Correctly identifies or discusses analysis and thoroughly answers all questions
Education and recommendations:Accurate information provided
- After you have recorded your 24-hour food intake, use an online analysis tool to estimate the amounts of energy and nutrients in the foods you have eaten in one day. Note the units indicated for each nutrient.
- Calculate the average of each nutrient based on the number of days of data.
- Compare the average of each of the nutrients to the RDA. Use the RDA Tables (online).
- Express your intake of energy and each nutrient as percentage of the RDA (standard).
(Average Value of Nutrient)x 100%
- Use your gram total for protein, fat, and carbohydrate (energy-rich foods) to calculate the quantities and percentages of calories you consumed from each energy nutrient and from alcohol.
Use the Calorie Calculation Form.
1 gram protein = 4 kcal
1 gram carbohydrate = 4 kcal
1 gram fat = 9 kcal
1 kcal = 1000 calories
- Using the information in steps 3, 4, 5, and 6 compare your diet to:
- The recommended percentage of energy nutrients
- The Dietary Guidelines
- Submit a photocopy of all your forms, your original record and your summary.
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