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 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??